Consent to Release Information Form

Consent to Release Information

Required Before PCEF Scholarship Disbursement
As a recipient of a Person County Education Foundation Scholarship, it is important to take the time to thank scholarship donors for their support. Receiving a thank-you letter allows a donor to view the impact their scholarship gift has in helping a deserving student realize his/her potential.

Thank you letters recognize the contributions of scholarship donors, as well as highlight the achievements of the recipients benefiting from scholarship support. The sharing of personal successes, career goals, and genuine gratitude is meaningful to supporters and significantly impacts future philanthropy. For these reasons, the PCEF occasionally highlights quotes from scholarship recipients to use in online and print publications shared with the community.
Full Name
Email:
example@example.com
Please check below to indicate your agreement to share your scholarship thank-you letter (in whole or part) in the following formats:

I consent to allow my scholarship thank-you letter to be sent directly to the scholarship donor supporting the scholarship which I have received (required).I consent to allow my scholarship thank-you letter, or portion of it, to be quoted on online PCEF-related websites such as www.personcoeducationfoundation.orgI consent to allow my scholarship thank-you letter to be printed/quoted in PCEF print materials including brochures, annual reports, and newsletters.I consent to allow my digital photo to be sent to the scholarship donor.I consent to allow my digital photo to be used in print materials, and/or used on the PCEF website or social mediaI would like to have a short video clip filmed of me to use on online promotional materials and/or to send to the scholarship donor in appreciation of their support.I am interested in paying forward the donation that made my scholarship award possible by volunteering to assist at a PCEF event.
Signature

Clear
Date

MonthDayYear
Date
Name of Scholarship
Program of Study
Anticipated Graduation Year
Please return this form with your scholarship thank you letter.

You can submit your letter via:
- Online - Upload your Thank You Letter https://form.jotform.com/PCEF_Roxboro/thank-you
- Email (pcefscholarships@gmail.com)
- Mail (P.O. Box 845, Roxboro NC 27573)
Should be Empty: