Miss America National/Foundation Scholarship Request Form

Miss America National/Foundation Scholarship Request Form

Please note each request requires a separate form

Contestant Information

First Name

MI

Last Name

Email

Confirm Email

Phone

Last 4 SSN

Birthdate

High School Name

High School Graduation Year

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

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

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

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

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

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Student Loan Documentation

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

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

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Official transcripts which show completion of coursework

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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

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Class schedule and syllabus reflecting educational expenses purchased

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Please contact Jamillah Hamilton at jamillah@missamerica.org or 609-344-1813 with any questions.

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