Scholarship Disbursement Form

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Scholarship Disbursement Form

I would like to recommend that the Board of Directors of the Fresno Regional Foundation disburse an award to the following student:
Please complete the following form to request a scholarship disbursement. Note: Fields that contain an * are required.

Scholarship Recipient Details

Date

Student's Name *

Note: All Scholarship checks will be made payable to both the student and the post-secondary institution.

Student's ID *

Student's Address *

Student's Phone Number *

Student's Email *

Post-Secondary Institution Details

Post-Secondary Institution *

Post-Secondary Institution Mailing Address

Institution's Phone Number

Scholarship Fund Details

Scholarship Fund *

Scholarship Disbursement Date *

Scholarship Type *

Scholarship Amount *

Special Instructions/Restrictions *

Multiple Disbursement Upload

Attach File (100Mb Limit)
Sample:
Scholarship Disbursement Form (13 KB)

If your fund is awarding multiple scholarship recipients. Please attach an excel file with contact information for each student.

Scholarship Committee Chair Details

I acknowledge the scholarship recipient is not related to any member of the scholarship selection committee or substantial donors to the scholarship fund and that the scholarship selection committee has been included in the scholarship recipient selection process (Complete Selection Committee List).

Full Name *

Email Address *

Work Phone Number *

Charitable solutions

Philanthropic acts combine the best of social responsibility with deep commitment to service and community. Our staff supports both you and your client in seeking the best possible solutions for individual charitable giving.

Our donors (and your clients) are making good works possible in our community and realizing their charitable goals.

Read their stories.

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