Stoughton High School 2019-20 Scholarship Information Form
Please submit no later than January 11, 2020
Name of Scholarship: *
Name of organization awarding this scholarship: *
Number of scholarships to be awarded: *
Total amount of scholarship(s): *
Scholarship contact person: *
Contact person's email: *
Scholarship contact person phone#: *
Alternate phone number:
Will your organization provide someone to present the scholarship at the Honor's Program: *
Please note that we strongly encourage you to send someone from your organization to present.
Required
Name of your presenter:
Email for your presenter: (We will email details of the night)
Phone number of your presenter:
Would you like a high school staff member to present your scholarship? *
Required
Complete name and address of who should receive the thank you note *
Please describe specific criteria for your scholarship(s): *
Please do not say "same as last year".
Please indicate the requirements for collecting the scholarship: *
Please check one
Required
Please indicate who the scholarship should be paid to: *
Please check one
Required
Please indicate who will disburse the scholarship to the recipient: *
Please note if you would like to have the school district disburse the funds, you will need to get payment to our business office in by June 30th. (SASD-320 North Street, Stoughton, WI 53589)
Required
Please provide other instructions or details regarding your scholarship.
PLEASE SUBMIT NO LATER THAN JANUARY 11th
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