Faculty Scholarship Chair Sign-off
Ferla-Pohle 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_________________________________ e-mail ____________________________________
1. Has the selected recipient completed one-year at CCRI? Yes__ No__
2. Is the selected recipient enrolled in Business Administration Department courses? Yes__ No__
3. Is the selected recipient planning to continue his/her studies at CCRI? Yes__ No__
4. Of all applicants, does the selected recipient demonstrate the most overall potential for success?
Yes__ No__
5. Does the selected recipient meet all scholarship eligibility requirements? Yes__ No__
Comments
How many applications were received? _________
Who was on the selection committee?
_______________________________
_______________________________
_______________________________
_________________________________________________________
Business Administration Department Chair’s Signature/ Date
