Scholarship Disbursement Request

Student Information

Scholarship Claim Form
Your Name:*

First NameLast Name
Email Address:*
Email
Phone Number:*

Area CodePhone Number
Name of the ISF Scholarship Awarded:
Would you like to claim part of your scholarship now or defer scholarship disbursement for a later time?*

Claim NowDefer for Later (no amount will be sent out)

Disbursement Requirements
Please note: To request a disbursement, you must meet the following requirements:
- Enrolled in 12 credit hours
- Have a balance showing on your bill
- Must have a minimum cumulative GPA of 2.25
You will be required to upload your full schedule showing hours, your school bill, and your transcript (other than first-year students). Please have these documents on hand.

Also, please note per the scholarship agreement that was signed by you upon accepting your scholarship, it is your responsibility to request a disbursement at least 3 weeks prior to your payment deadline. It takes up to two weeks for ISF to process your request and mail your check to your university.

ISF will send checks directly to the university* and not reimburse students directly. Only under special circumstances will this be approved by the CEO/President.

*2024 Recipients: Foundation policy has changed and disbursement checks will no longer be made out to the scholar and the school, requiring two endorsements and delivery to school business office for deposit. All payments will be sent directly to the school.

College/University Information

Scholarship Claim Form
College/University Name:*
Complete address of where payment is to be sent. Payments are sent directly to College/University unles you are an Ellis Scholar.*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
College/University Student ID:*
For which semester are you submitting this Claim or Defer request?*
How many hours are you enrolled in for the semester you are requesting a disbursement or deferment?*
How much are you requesting to be disbursed?*
Please put dollar amount to be sent to your school not exceeding your bill balance.
Are you a Joy and Ralph Ellis Scholarship Recipient?*

YesNo
Where would you like your disbursement sent?

Directly to my university provided above.To me please.
Please provide your mailing address.

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
How much are you requesting to be disbursed?*

Other

Required Documentation

Scholarship Claim Form
Current school bill with a balance.*

Browse Files
We cannot pay from a $0 due invoice or negative balance. Cancelof
Schedule showing course hour credit for the semester requesting funds for.*

Browse Files

Cancelof
Is this your first semester of college?*

YesNo
Click to upload unofficial transcript showing cumulative GPA.*

Upload a File
Max Total Upload Size: 500MB Cancelof
Additional Items:

Browse Files
Not required Cancelof

Defer Disbursement

Scholarship Claim Form
For which semester are you requesting a deferment?*
Please explain why you would like to defer your scholarship disbursement for approval.*
Please Notes: A deferment request must be completed at the beginning of each semester to continue to hold your scholarship.

Please click submit to complete your request.
If you have any additional notes to ISF please share here:
Type a question
Please verify that you are human*