Please complete the following questions to claim your ECMC College Nights scholarship award.

Questions? Email collegenights@ecmc.org —we’re here to support you!

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* 1. First name

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* 2. Last name

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* 3. Phone number

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* 4. Email address
(Be sure to enter the email address you check most often—we’ll use it to reach out if we have any questions about your request)

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* 5. Parent/guardian email address
(If we need to reach out with any questions, we’ll also loop in your parent or guardian to keep everyone informed)

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* 6. High school where you won your award

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* 7. College name

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* 8. College address where scholarship check should be sent (If you are unsure, check your college's website and/or contact the Financial Aid Office.)

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* 9. College student ID number

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* 10. Which academic year are you requesting a disbursement for?

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* 11. Which term are you requesting a disbursement for?

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* 12. Upload evidence of enrollment for the term that you want the scholarship funds to be applied. The document must include your first and last name, college name and term preprinted on it. Examples include:
  • Copy of your class schedule
  • Copy of your tuition bill
  • Enrollment verification form from your college

Note: Acceptance letters and financial aid offers do not qualify as proof of enrollment.

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Once your request is received, please allow up to four weeks for processing and delivery. The check will be mailed directly to the college address provided.

You will not receive a confirmation or follow-up unless we have a question about your request. If needed, we will contact you via email from collegenights@ecmc.org.

Questions? Email collegenights@ecmc.org

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