Principal Investigator:
Department Name: Phone: Email:
Project Title:
Sponsor:
PeopleSoft Chartfield:
Semester: Year:
Net ID
Peoplesoft ID
Amount
_____ Recipients meets program scholarship eligibility requirements.
_____ Recipients are current on all program requirements and is eligible to receive the requested disbursement.
Additional Institutional responsibilities (see award terms and conditions for student repayment instructions)
Date
Date
Rev 07 2018
Principal Investigator / Project Director Signature
Grants & Contracts Manager Signature
Instructions:
4 weeks before the start of each quarter, submit this form to verify the students continued involvement
with the project
Only submit this form if a Scholarship Recipient Authorization with contracts are on file
SCHOLARSHIP ELIGIBILITY FORM
Award Recipient Name
Account - Fund - Dept ID - Project
0.00