2023 Scholarship Remittance Form - The Community Foundation for Greater New Haven

Universal Remittance Form

Please submit this form by June 2, 2023

Question Title

* 1. Name of Scholarship Fund (one scholarship per form):

Please complete the following for each scholarship recipient.
SCROLL to Question 9 to complete the form after your students have been entered.
(If you have more than 7 scholarship recipients, email Deb Wright at dwright@cfgnh.org
with the additional student information)

Question Title

* 2. Student No. 1

Student's First Name

Student's Last Name

College or University

Field of Study

Award Amount

Question Title

* 3. Student No. 2

Student's First Name

Student's Last Name

College or University

Field of Study

Award Amount

Question Title

* 4. Student No. 3

Student's First Name

Student's Last Name

College or University

Field of Study

Award Amount

Question Title

* 5. Student No. 4

Student's First Name

Student's Last Name

College or University

Field of Study

Award Amount

Question Title

* 6. Student No. 5

Student's First Name

Student's Last Name

College or University

Field of Study

Award Amount

Question Title

* 7. Student No. 6

Student's First Name

Student's Last Name

College or University

Field of Study

Award Amount

Question Title

* 8. Student No. 7

Student's First Name

Student's Last Name

College or University

Field of Study

Award Amount

Question Title

* 9. Please describe your selection process for scholarship recipient(s). This question needs to be completed for the current year's process; please do not answer "same as last year."

Question Title

* 10. In the space below, please list your committee members with titles. This question needs to be completed for the current year's process; please do not answer "same as last year."

Question Title

* 11. Person completing this form:

Name

Organization

Address

City/Town

State

Zip Code

Email Address

Phone Number