2024 State Teen Scholarship Request

2024 STATE TEEN SCHOLARSHIP REQUEST
Deadline: June 21, 2025 OR
within one year of high school graduation - whichever is later

Please use this form to requests scholarship dollars earned at the 2024 Miss Wisconsin's Teen state competition. This form should not be used for requesting local scholarships.

Please review this entire form thoroughly before completing - to ensure you have all pieces of required information. We will not be able to process any requests that are missing ANY INFORMATION. Unfortunately, this is not flexible - so please follow the instructions precisely. If the request is incomplete, receipt of your scholarship WILL BE DELAYED.

If you have any questions, please email scholarships@misswisconsin.com

Please review the SCHOLARSHIP RULES AND REGULATIONS

Candidate Name*

First NameLast Name

Candidate Email*

example@example.com

Candidate Phone Number*

Area CodePhone Number

Candidate Birthdate*

Date

High School Graduation Date*

Date

Local Title at 2024 State Competition*

Last 4 Digits of SSN*

College Name*

College Major*

Candidate Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Prior to requesting and receiving any scholarships from the State Organization, the Candidate must have received all LOCAL scholarships.

Please have your Local Director sign the Local Scholarship Request and Affidavit and upload here to confirm that your local level scholarships for 2023 are fully paid.

Upload Signed Affidavit*

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2024 Teen Scholarship Award Earned*

2024 Teen Scholarship Award Earned

Total Requested

Make Check Payable To:*

School or loan company. Checks will not be written to individuals.

Student ID or Loan Payment Account #*

As shown on tuition bill or loan bill

Payment Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Payment Type

Tuition/Room & Board (payable to school)Educational Loan (payable to loan servicing provider)

Upload Promissory Note (required only for loan payment)

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Upload Transcript (unofficial is acceptable)*

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For incoming freshman, upload a copy of your letter of acceptance or other proof of enrollment.

Upload Tuition or Loan Bill*

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Must be dated within the last twenty (30) days and must show an amount due that is greater than or equal to the amount being requested

Please Confirm:*

The date shown on this bill is no more than 30 days prior to today's date

Please Confirm:*

The amount due, as listed on the bill, is greater than the amount of this request

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