Faculty Scholarship Chair Sign-off
Frank A. Orth 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.
If you plan to have the award announced at Class Night and/or want the award listed in the Class Night Program Booklet, contact Jean Lovett, Office of Student Affairs at the Lincoln Campus (x7159).
Name ____________________________________________ Student I.D. #______________________
Address___________________________________ City__________________ State______ Zip________
Telephone__________________________________ email______________________________________
1. Is the selected recipient enrolled in the Business Administration Program at CCRI? Yes__ No__
2. Has the selected recipient distinguished himself/herself in Business Administration? Yes__ No__
3. Is the selected recipient planning to continue his/her studies at CCRI? Yes__ No__
4. Does the selected recipient meets all the scholarship eligibility requirements? Yes__ No__
Comments
How many applications were received__________
Who was on the selection committee?
_____________________________
_____________________________
_____________________________
Who will be presenting the award at Class Night ________________________________
______________________________________________________
Business Department Chair Signature/Date
