Student Application Form
Ferla-Pohle Scholarship
Instructions: Please print clearly or type. Return completed form to:
Ferla-Pohle Scholarship Committee
c/o Business Administration Department Chair
Community College of Rhode Island
400 East Avenue
Warwick, RI 02886-1807
Applications must be hand delivered by 4 p.m. or postmarked no later than April 1.
Name________________________________________ Student I.D. #_____________________
Address_________________________________ City________________ State____ Zip_______
Telephone__________________________________ email_______________________________
1. Have you completed your first year at CCRI? Yes__ No__
2. Are you continuing in the Business Administration Department program? Yes__ No__
3. What is your overall G.P.A? ___________
4. Why should you receive this award? (Attached additional pages as necessary, please include college and/or community activities.)
5. Have you applied for other CCRI scholarships, funds or awards? Yes___ No___
If yes, please list:
I grant my permission to the Scholarship Review Committee to review my academic standing with CCRI’s Office of Admissions and Records, to review my financial need with CCRI’s Financial Aid Office, and to use my name and photo for publicity purposes.
__________________________________________
Student Signature/Date
Important Note: Scholarship recipient is required to write a thank you note (memo and sample thank you note) to the scholarship donor, and provide a brief biography (printable bio form) about themselves and their education/career goals and return both to: Geraldine Peixoto, CCRI Foundation, Flanagan Campus, 1762 Louisquisset Pike, Lincoln, RI 02865. Please contact the CCRI Foundation if you need assistance in completing this responsibility at 333-7150 or e-mail at foundation@ccri.edu.
