Student Application Form
Liberty Mutual Business Scholarship
Instructions: Please print clearly or type. Return completed form to:
Liberty Mutual Business Scholarshipc/o Business Administration Department Chair
Community College of Rhode Island
1762 Louisquisset Pike
Lincoln, RI 02865
Applications
must be hand delivered by 4 p.m. or postmarked no later than April 1.
Name________________________________________ Student I.D. #_____________________
1. Are you continuing your education at CCRI? Yes__ No__
2. Are you enrolled in the Business Administration Department at CCRI? Yes__ No__
3. List community activities/services you have been involved in (use a separate sheet as necessary).
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.
