Fillable Scholarship Certification Form Some scholarships require yearly certification (New Jersey Institute of Technology)

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Scholarship Certification Form Some scholarships require yearly certification (New Jersey Institute of Technology)

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Scholarship Certification Form
NJIT ID _____________________
Some scholarships require yearly certification in order to retain eligibility for multiple reasons. As a
recipient of one of these scholarships, you will be required to yearly certify eligibility to ensure that you
continue to meet the requirements requested by the donor/company. Please complete the personal
information section below and the special circumstance information that is applicable to your
scholarship.
This form must be completed, signed and uploaded via MappingXpress or feel free to bring the
completed form at the Financial Aid Office. Please note that if not received scholarship(s) will be
canceled.
Personal Information
Name __________________________________ _______________________________ ________
Last First M.I.
Special Circumstances
Please check the box of the circumstance that is applicable to your scholarships and complete the
required information.
Internship Consideration
I certify that I am willing to consider an internship with the company/donor related to my scholarship for the
2019-2020 academic year.
Co-op Consideration
I certify that I am willing to consider an internship with the company/donor related to my scholarship for the
2019-2020 academic year.
Involved in extracurricular activities including community service and/or sports
I certify that I will participate in extracurricular activities for the 2019-2020 academic year.
Employment Status
I certify that I am/will be employed at least part-time for the 2019-2020 academic year.
I certify that I will not be employed for the 2019-2020 academic year.
____________________________________________ ________________________
Student Signature Date
Upload Completed Form/Documents to:
https://mappingyourfuture.org/MappingXpress/NJITFA/
Mail or Fax:
Student Financial Aid Services
NJIT - Student Mall, University Heights
Newark, NJ 07102 Fax: 973-596-6471
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Scholarship Certification Form Some scholarships require yearly certification (New Jersey Institute of Technology)

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Completed 24 August 2020

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