Outside Scholarship Form
Please complete the form below for each Outside Scholarship (scholarship or grant from a source other than federal, state, or Allegheny funding) you will be receiving for the upcoming academic year.
Email address *
Student's Full Name *
Your answer
Student ID Number *
Your answer
Name of Outside Scholarship Foundation *
Your answer
Scholarship Amount *
Your answer
Scholarship Check will be mailed to: *If the check is mailed to the student, the student is responsible for notifying the Financial Aid Office of receipt of funds. *
Scholarship check will be made out to: *
In order for Allegheny College to provide necessary information to an Outside Scholarship Foundation to issue the scholarship funds, federal regulations require that we obtain your written permission before we can release your information to anyone not directly involved in the administration of these areas within the College. If you have any questions regarding this matter, please do not hesitate to contact the Financial Aid Office at 814-332-2701. I give Allegheny College permission to release any information pertaining to my academic or financial record, including my academic transcript, financial aid information, billing statement and personal information (Address, Social Security Number and Allegheny I.D. number) each time it is required by the above named Outside Scholarship Foundation. I understand that I can rescind my permission at any time, by submitting a written and signed request to rescind to the Office of Financial Aid, Allegheny College. *
Required
Submit
Never submit passwords through Google Forms.
This form was created inside of Allegheny College. Report Abuse - Terms of Service