University of the Incarnate Word
Office of Financial Assistance
Athletic Outside Aid Award Form
4301 Broadway, Box 308
San Antonio, TX 78209
Phone: (210) 829-6008
Fax: (210) 283-5053
Revised 06/2017
We have received notification that the student listed below has received an outside scholarship for UIW. The
NCAA requires verification of the criteria that was used in the selection process for the scholarship recipient.
UIW cannot apply the scholarship to the student’s account until the form has been completed by a
representative from the scholarship organization and the full awarding criterion has been disclosed.
Student Name UIW ID
Scholarship Name Scholarship Amount
Organization Name and Address
To be completed by a representative from the scholarship organization:
STEP 1: Confirm the Scholarship Awarding Criteria
Please check all statements that describe the characteristics of the award:
o The award does not have any relationship to athletics ability.
o The award is from an established and continuing program to aid students.
o The recipient's choice of institutions is not restricted by the donor of the aid.
o The awarding individual or organization and the donor of the aid are not representatives of UIW athletics
interests or an athletic booster group of UIW.
o There is no direct connection between the donor and UIW.
STEP 2: Attach a copy of the scholarship application
Please attach a copy of the application for this scholarship to this form. If the student’s scholarship application
is not available, a copy of the general application for this scholarship is permissible. If there is not an
application that is needed for consideration of this scholarship, please provide a letter of explanation on how the
recipients of the scholarship are determined.
STEP 3: Complete the Donor Certification
Your signature on this form confirms your acknowledgement of the following:
o You have disclosed all of the awarding criteria used to issue the student this award.
o UIW will return the award to the donor if it is determined that it does not meet NCAA requirements.
_______________________________ _______________________________
Representative’s Signature Date
_______________________________ _______________________________
Representative’s Printed Name Representative’s Email Address
Please return to Mimi Nguyen as an e-mail attachment to (