Outside Scholarship Form

Name*

First Last

Date of Birth*

Scholarship #1

Name of Scholarship*

Address of person/organization supplying the scholarship

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Who will the check be made out to?*

You personally
University of Jamestown
Both

Amount of scholarship for the year*

Please enter a number greater than or equal to 0.

Amount Applied to Fall*

Please enter a number greater than or equal to 0.

Amount Applied to Spring*

Please enter a number greater than or equal to 0.

Amount Applied to Summer*

Please enter a number greater than or equal to 0.

Documentation that identifies the scholarship is required*

Accepted file types: pdf, jpg, png, docx, Max. file size: 100 MB.

Thank you for taking the time to complete this form.

If you have any questions, please feel free to contact the Financial Aid Office at (701) 252-3467, extension 5556 or email UJfinaid@uj.edu.