2016-2017 Scholarship Information
Please share all scholarships you are offered, even if you do not accept the scholarship or are attending a different school. You may summit this form multiple times as scholarships are received.
Student's Last Name:
Your answer
Student's First Name
Your answer
School Counselor's Name:
Choose from the list
List all scholarship name(s) you have been offered.
Example: Brenda Wolf Scholarship (Tremper High School) $1000.00
Your answer
Total Amount of scholarship(s) you have been offered
Example: Brenda Wolf $1000 & UW-Madison $25,000 Total = $26,000 Also indicate if the scholarship is for 1 or 4 years.
Your answer
Please provide a copy of verification to Mr. Tarkowski by May 20th
If you you receive a scholarship after May 20th, contact Mr. Tarkowski ASAP prior to June 13th
Required
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