THE UPS SCHOLARSHIP NOMINATION FORM
for Academic Year 2020-21
This year the UPS Scholarship Fund will offer a scholarship gift of $ 3,000 per AICUP member institution, to be
awarded to ONE student the school chooses.
CIC has become more prescriptive in how it wants the scholarship awarded. In a
letter to AICUP, CIC’s
Carol Shuler states: “. . . At each college, the scholarship is to be awarded in its entirety in one allocation
to a full-time, undergraduate student whose background reflects one or more of the characteristics of the
student population that is of highest priority to the UPS Foundation and CIC’s First Opportunity Program:
first-generation, low-income, minority, or new American students.”
After selecting the student to receive this scholarship, please complete the following form for the recipient.
Completing this form will allow us to report accurately the distribution of the UPS money.
Please note that the selected student must send a thank-you note to CIC for the scholarship.
Please complete the form below and return it to AICUP via Sharefile and the upload link you
were provided no later than Friday, April 24, 2020.
All forms MUST have the student’s signature (printed or electronic).
Institution Name:
Student
Information
(Please print or
type)
Name (First and Last):
Current Address:
City: State: Zip:
Permanent Address (if different):
City: State: Zip:
Which address should we use for mailing?
Student campus email address:
Academic Information
Major: Minor:
Cumulative GPA: GPA in major:
Freshman Sophomore Junior Senior (
Check one)
Date of Graduation:
Release Authorization
I certify that to the best of my knowledge this information is true, complete and accurate. I authorize
the release of information to confirm and/or verify this application. I also agree to be contacted in
subsequent years in order for AICUP
and/or CIC
to request follow-up information about my whereabouts
and activities understanding that provision of such information is entirely voluntary.
All forms MUST have the student’s signature, either printed or electronic, for submission.
Student Signature: Date:
click to sign
signature
click to edit
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