Miss America National/Foundation Scholarship Request Form

Miss America National/Foundation Scholarship Request Form

Please note each scholarship requires a separate online form

Contestant Information

First Name

MI

Last Name

Email

Confirm Email

Phone

Last 4 SSN

Birthdate

College Name

College Major

Ethnicity

Address

Address Line 1

Address Line 2

City

State

Zip Code

Scholarship

Is this request for a National or a Foundation scholarship?

Competition Year

Award Type

Make Check Payable To:

School address for tuition payment. Account number for loan payment. Home address for educational expenses reimbursement.

Student ID for tuition payment. Account number for loan payment.

Comments

Request

Total Request Amount

$

Expense Type

Tuition/Room & BoardStudent LoansEducational Expenses

The following items are required to process your request. Please check each item you have attached:

Tuition/Room & Board Documentation

Current detailed tuition statement from university (no later than 30 days) with school ID# and remittance address

Upload your document

Room and board requests require a tuition statement reflecting full-time status of 12 credit hours

Upload your document

Student Loan Documentation

Current bill and/or bills from the lending institution. Include loan #, student's name and payment address

Upload your document

Copy of the promissory note(s) which reflects you are the primary payer of the loan

Upload your document

Official transcripts which show completion of coursework

Upload your document

Educational Documentation

Original receipts: If paid by other than cash, a credit card statement or copy of cancelled check (front & back) must accompany the receipt

Upload your document

Class schedule and syllabus reflecting educational expenses purchased

Upload your document

Please contact Lani LiCalzi at lani.licalzi@missamerica.org or 609-344-1813 with any questions.

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