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MISSISSIPPI VALLEY STATE UNIVERSITY (Mississippi Delta Community College)

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MISSISSIPPI VALLEY STATE UNIVERSITY
FACULTY/STAFF
RECIPROCAL SCHOLARSHIP FORM
MDCC Applicant:
MVSU ID #
(do not use social security #)
Semester and Year Applying For:
Course Number, Description, and Hours (6 hours maximum) Applying For:
Employee Date
Appropriate Supervisor Date
Associate Vice President / Vice President Date
President Date
After all signatures have been obtained, the President’s office will forward this form to Human Resources. HR will then email a
copy of the approved form to employee. Employee will then be responsible in taking form to MVSU.
Updated 11/17/20
Mississippi Delta Community College does not discriminate on the basis of age, race, color, national origin, religion, sex, sexual
orientation, gender identity or expression, physical or mental disability, pregnancy, or veteran status in its educational programs
and activities or in its employment practices. The following person has been designated to handle inquiries regarding the nondiscrimination policies:
Steven J. Jones, Vice President of Administrative Services, Tanner Hall, Suite 202, P. O. Box 668,
Moorhead, MS 38761, 662-246-6304; EEOC@msdelta.edu
(Schedule must be attached)
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MISSISSIPPI VALLEY STATE UNIVERSITY (Mississippi Delta Community College)

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Completed 3 February 2021

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