Faculty Scholarship Chair Sign-off
Liberty Mutual Business Scholarship
Instructions: Complete this form, sign and date it, and return the form along with ALL the scholarship applications to: Geraldine Peixoto, CCRI Foundation, Flanagan Campus. Upon receipt of all the applications and the sign-off form, the Office of Institutional Advancement will process the scholarship award within two weeks and mail the check to the selected recipient.
Name_______________________________________ Student I.D. #___________________________
Address____________________________________City___________________ State____ Zip______
Telephone______________________________________ email________________________________
1.Is the selected recipient continuing their education at CCRI? Yes__No__
2.Is the selected recipient enrolled in the Business Administration Department at CCRI? Yes___ No__
3. Has the selected recipient listed community/school activities he/she has participated in?Yes__ No__
4. Does the selected recipient meet all scholarship eligibility requirements? Yes__ No__
Comments:
How many applications were received? ________
Who was on the selection committee
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Scholarship Chair Signature / Date
