MUST BE TYPED After July 1, please allow 15 business days for processing with extended periods during peak times.
College / Department Scholarship Name
Contact Person Phone # Banner Chart & Index #
Academic Year
Name of Recipient
New
Award
Increase
Prior
Award
Decrease
or Cancel
Prior
Award
Fall
Amount
Spring
Amount
Summer
Amount
Total
Comments:
Dean / Chair Signature
Date:
Typed Dean / Chair Name
I certify that the recipients listed above meet or exceed the criteria established for this scholarship. Incomplete forms will be returned for completion prior to processing. Scholarships with insufficient funds will not be processed.
Chart E Scholarships - Send Form To: Financial Aid Office, Box 70722
Chart F Scholarships - Send Form To: Foundation Accounting, Box 70732
OFFICE USE ONLY
AR Detail Code:
Fund #:
Foundation Approval:
Date:
East Tennessee State University
Scholarship Authorization Form
Exempt # / Fund Code / Detail Code (if known):
Authorized Amount
Select One per Student
Student ID
Enrollment Level
Required (i.e. Full
time, Half Time, # of
hours required, etc)
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00