Legacy Scholarship Initiative Entry Form
Thank you for your interest in our scholarship. Peggy Arnold will be in contact with you to discuss further details. If you have any questions, feel free to email scholarships@chiul.org.
Your Full Name
*
First Name
Last Name
Your Email Address
*
example@example.com
Your Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Who are you honoring with this scholarship?
*
Do you have specific requirements or criteria for this scholarship?
Scholarship Amount (per award)
*
Number of Scholarships to be Awarded
*
Submit Scholarship Entry
Should be Empty: