AY2021-2022 AHLA Foundation Scholarship Payment Form
This form must be completed for processing of AHLA Foundation Scholarship funds
Step 1: Student Completes Section A
Step 2: School/Financial Aid Office Completes Section B
Step 3: Student Uploads Completed Form via ahlafoundation.scholarshipapps.org
Section A (to be completed by the student):
Name: ________________________________________________
Date of Birth: _________________________ Student ID Number: ___________________________
Student’s Initials: _________ By initialing, I authorize my school to provide all information requested.
Section B (to be completed by school representative):
Student’s Enrollment Status:
(mark one)
____ Student will be/is currently enrolled full time in AY2021-2022
____ Student will be/is currently enrolled part-time in AY2021-2022
Student’s Declared Major: ______________________________________________________________
NOTE: Scholarship checks are mailed directly to the school; please provide the appropriate
mailing address for scholarship funds to prevent any processing delays.
School Name: ______________________________________________________________________
School Address: ______________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
School IPEDS ID: ____________ IPEDS ID can be found at https://nces.ed.gov/collegenavigator/
Completed by:
Signature and Date: _____________________________________________________________
Name of Authorized Representative: _________________________________________________
Title of Authorized Representative: __________________________________________________
Contact E-mail and Phone: _________________________________________________________
Form must be returned to student and uploaded through their scholarship dashboard at: ahlafoundation.scholarshipapps.org
Incomplete or incorrect forms will be rejected and cause processing delays.
