2019 Scholarship Award Form

This form is to be completed by those scholarship winners who have previously been notified.

Deadline: Complete this form by August 1, 2019 (scholarship funds will be mailed to the college around September 6, 2019)

Scholarship Award

Student College ID #*
Name*
First Last
Address*
Street Address Address Line 2 City State ZIP Code
Phone*
Email*
College/University
College/University Name*
Name of Contact*
Mailing Address*
Street Address Address Line 2 City State ZIP Code
Phone*

Funding for scholarships is in accordance with Georgia’s unclaimed property laws, O.C.G.A. § 44-12-236. For more information, please contact Stacey Fields, Director of Public Relations, at 706-253-5287.

2019 Scholarship Award Form

Scholarship Award

College/University

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