Scholarship Remittance Info
Information Needed for Scholarship Payment
Student Name
First Name
Last Name
Student Email
example@example.com
Student ID #
Enrollment Verification
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Student Mailing Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Student Phone Number
Please enter a valid phone number.
Information so we know where to send your scholarship check:
School Name
School Mailing Address (include Attn: name of responsible office or person)
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
To whom should we make the check payable to? (ie: Student Financial Affairs, ...)
Phone Number of responsible office or person at your school
Please enter a valid phone number.
Email of responsible office or person at your school
example@example.com
Student Account #
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