Request edit access
Scholarship Award Information
If you have been awarded a scholarship that is managed through the ICCSD Foundation, we will need some information from you in order to process the award. Please complete and submit your information by June 15.
What scholarship were you awarded?
Bud Williams Cross Country Scholarship
Christian A. Green Memorial Scholarship
City High Scholarship
City High Class of 75 Silver Cord Scholarship
City High Musician-Athlete Scholarship
David Braverman Community Service Scholarship
Diana Paulina Memorial Scholarship
Don Gatens Memorial Scholarship
Dorothy Grove Memorial Violin/Voice Scholarship
DPO Education Scholarship
Jean McKnight O'Connor Music Scholarship
John Raffensperger Scholarship
Kathy Riddle Memorial Scholarship
Levy Growth Mindset Scholarship
Marjorie Anderson Smith Business Scholarship
Pamela R. (Heck) Jones Friendship Award
Russell and Helen Memorial Scholarship
Sidney and Janice Tribbey Family Scholarship
Sister Margaret Dane Hansen Ambassador Scholarship
University of Iowa DeGowin Blood Center Scholarship
Student First Name and Last Name
Home Address 1:
Home Address 2
City, State, Zip Code:
College/University Attending in 2017-2018 Academic Year:
Student College/University ID Number:
Where should scholarship money be directed?
Scholarship awards will be sent in July to the school you plan to attend in the fall. Each school does this a bit differently, but most schools ask that scholarship checks be directed to the Bursar or Business Office or the Office of Financial Aid. Some request a specific form be completed to accompany a scholarship check. Please contact your school or visit their website to determine which office should receive a scholarship check to be credited to your account. Please submit any form that must be sent with the scholarship check to
Name of College/University office to receive check:
Address (Line 1) of College/University office to receive check:
Address (Line 2) of College/University office to receive check:
City, State Zip of College/University office to receive check:
Does your school require a form to be submitted with the scholarship check?
Yes, I have emailed the form to
Scholarship checks will be sent directly to your school in July. You will receive notice via email when the check has been sent. For additional questions, contact Theresa Weeks at the ICCSD Foundation at
Never submit passwords through Google Forms.
This form was created inside of ICCSD.
Terms of Service