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Outside Scholarship Form

Outside Scholarship Form

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Scholarships

Name*
First Last
Date of Birth*
MM slash DD slash YYYY
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 coming in semester 1*
Please enter a number greater than or equal to 0.
Amount of coming in semester 2*
Please enter a number greater than or equal to 0.

Add Another Scholarship

Scholarship #2

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 coming in semester 1

Please enter a number greater than or equal to 0.

Amount of coming in semester 2

Please enter a number greater than or equal to 0.

Add Another Scholarship

Scholarship #3

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 coming in semester 1

Please enter a number greater than or equal to 0.

Amount of coming in semester 2

Please enter a number greater than or equal to 0.

Add Another Scholarship

Scholarship #4

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 coming in semester 1

Please enter a number greater than or equal to 0.

Amount of coming in semester 2

Please enter a number greater than or equal to 0.

Add Another Scholarship

Scholarship #5

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 coming in semester 1

Please enter a number greater than or equal to 0.

Amount of coming in semester 2

Please enter a number greater than or equal to 0.

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.

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JAMESTOWN

6000 College Lane

Jamestown, ND 58405

(701)252-3467

PHOENIX

3110 N. Central Ave., Ste L-190

Phoenix, AZ 85012

(701)557-8071

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Physical Therapy

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Fargo, ND 58104

(701)557-8071

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Suite 208

Fargo, ND 58104

(701)557-8071

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