Fillable How To Start A Scholarship PDF

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How To Start A Scholarship PDF

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New Scholarship Form
Please use this form to establish the guidelines and criteria for a new scholarship.
I. What are your goals in establishing this scholarship? What do you hope to
accomplish?
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
II. Name of Scholarship: __________________________________________________________
☐ In honor of someone special
☐ In memoriam
☐ After yourself
If this scholarship is named after someone, please provide a brief description of the person for use
on the website and for other marketing material: ________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
III. Scholarship Criteria:
A. Enrollment Status :
☐ Full-time student (12 units or more)
☐ Part-time student (6 to 11.5 units)
☐ Other: ___________
☐ No Preference
B. Major Requirement:
☐ Specific major(s): ____________________________________________
☐ No Preference
C. Minimum Number of Units Completed:
☐No minimum
☐At least 12 units
☐At least 24 units
☐Other: __________
New Scholarship Form Cont. – Page 2
D. Minimum Grade Point Average:
☐ 2.0 GPA (C Average)
☐ 3.0 GPA (B Average)
☐ 4.0 GPA (A Average)
☐ Other: __________
E. Selection will be based more toward:
☐Financial Need
☐Merit
☐Both Financial Need and Merit
F. Program/Student Focus (Optional) – i.e. students with disabilities, veterans, or former foster
youth: ______________________________________________________________________
G. Additional scholarship criteria:
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
IV. Administration of Scholarship
☐ Declining Balance (One-time donation)
☐ Annual (On-going donation)
☐ Perpetual or endowed (interest earnings)
Special Instructions:
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
V. Scholarship Award Information
A. Scholarship Amount:
☐$500 (minimum)
☐$750
☐$1000 (recommended)
☐Other: _____________
B. Number of scholarships to be awarded: _____________
C. Semester Awarded: ☐Fall (November) ☐Spring (May) ☐Both fall and spring
D. Additional Information:
____________________________________________________________________________
____________________________________________________________________________
New Scholarship Form Cont. – Page 3
VI. Selection of Recipient
A. Method of Selection
☐Application Review (donor involved)
☐Interview (donor involved)
☐Selected by a Cerritos College Foundation Scholarship Committee
☐Selected by faculty/department
B. Would you be interested in personally presenting the scholarship to the recipient(s) at a
Cerritos College Foundation Board of Directors Meeting?
☐Yes ☐No
VII. Contact Information
Name: ______________________________________________________________________________
Organization (if applicable): ___________________________________________________________
Address: ____________________________________________________________________________
City: _________________________________________________ State: ___________ Zip __________
Home Phone: ________________________________ Cell Phone: _____________________________
Email: _______________________________________________________________________________
Thank you for your support of the
Cerritos College Foundation Scholarship Program.
Please direct the completed form and any questions to:
Cerritos College Foundation
Rachel Samarin
11110 Alondra Blvd., Norwalk, CA 90650
Phone: (562) 860-2451 X 2539
Email: rsamarin@cerritos.edu
Tax ID #95-3387108
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How To Start A Scholarship PDF

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Completed 23 June 2020

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