Faculty Scholarship Chair Sign-off
Pohle Scholarship for Business Administration
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. Is the selected recipient a Business Administration Department student? Yes__ No__
2. Will the selected recipient be continuing at CCRI? Yes__ No__
3. Of all applicants, does the selected recipient demonstrate the most overall potential for success?
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? ___________________________
_________________________________________
Department Chair Signature/Date
