Preferences (Not required)
☐ 1. Preference given to a minority student.
☐ 2. Preference given to a male student.
☐ 3. Preference given to a female student.
☐ 4. Preference given to a veteran or dependent of a veteran.
☐ 5. Preference given to a single parent.
☐ 6. Preference given to employees or children of employees from your company or organization.
☐ 7. Other: ________________________________________________________________________
Provision of the Funding
Please check the statement which best expresses your wishes:
☐ 1. Funding will be at $25,000 or more in order to permanently endow the scholarship.
Endowed gift amount: $_________
Only interest generated from the principal will be used for scholarship funding.
☐ 2. Funding will be on an annual basis at $__________ per year.
Annual donations of $1,000 or more qualify as a named scholarship.
☐ 3. Funding will be a one-time gift of $_________ to be used until funds are exhausted.
A minimum donation of $1,000 is required.
Disbursement of the Funding
Funds will be applied to the student’s financial aid account with few exceptions. If the scholarship amount
exceeds the cost of tuition, fees, and books, please indicate your preference:
☐ Refund any overage to the student for cost of living. Default if no selection is made.
☐ Retain any overage in the scholarship fund for future disbursement.
From time to time, a student may fall a few credit hours short of the requirement, either because s/he is in
a final semester before graduation, or due to course availability. Please indicate your preference:
☐ Prorate the amount of the award if the recipient maintains all other eligibility requirements.
Default if no selection is made.
☐ Select a new scholarship recipient.
Naming of th
e Scholarship
Annually funded scholarships and permanently endowed scholarships can be named in honor or in
memory of someone special.
Requested Name: __________________________________________________________________
Signature: __________________________________________ Date: _________________________
Please return this form to: Mail to Durham Tech Foundation, Attn: JaNel Moore
1637 Lawson Street, Durham, NC 27703
Email to moorej@durhamtech.edu or Fax to 919-536-7284
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