DeKalb County Community Foundation Scholarship Renewal Application
This form is for individuals who have previously received a renewable scholarship from the DeKalb County Community Foundation. To renew your scholarship your enrollment, major, and academic performance must continue to meet eligibility requirements of the scholarship.

For questions about whether or not you are qualified to renew your scholarship contact Anita Zurbrugg, Program Director, at anita@dekalbccf.org or call 815-748-5383.

First Name *
Your answer
Middle Name
Your answer
Last Name *
Your answer
Scholarship(s) you were awarded *
Your answer
What is the year you received the 1st installment of this renewable scholarship?
Your answer
Phone Number *
Your answer
Can you receive texts at this phone number? *
Primary E-Mail Address *
Your answer
Birth Date *
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Permanent Mailing Address
Only fill the fields in this section if your permanent mailing address has changed since you first received the award.
Address Line 1
Your answer
Address Line 2
Your answer
City
Your answer
State
ZIP Code
Your answer
College or University Information
Student Identification Number *
Your answer
What is the name of the college or university where you are pursuing your degree? *
Required
If you selected "other" in the previous list of colleges and universities, what is address for your college or university's Office of Financial Aid and Scholarships?
Your answer
Provide all mailing address information for your college or university's financial aid office in your answer above. Only students attending schools other than those listed need to complete this field. Your scholarship check will be mailed directly to this address.
What is your declared degree or area of study? *
Your answer
What is your current Cumulative GPA? *
Your answer
Scholarship donors may be interested in knowing more about you and your future plans. Please share a short description of your education and/or career aspirations.
Your answer
Signature
Recipient Signature (typed first & last name) *
Your answer
Date Signed *
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