Faculty Scholarship Chair  Sign-off

Arthur Chatfield Music 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 enrolled in the Associate of Fine Arts-Music Degree Program? Yes__ No__

2.  Has the selected recipient completed a minimum of nine (9) credits in the  Associate of Fine Arts
     Degree Program? Yes__ No__

3.   Is the selected recipient pre-registered for a minimum of six (6) credits in Music? 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?

_______________________________

_______________________________

_______________________________

 

________________________________________
Music Department Chair’s Signature/Date

OIA USE ONLY

Payable to:

  • Student only
  • Student & CCRI
  • Student & 4-year Institution
  • Acceptance Letter
  • Award Amount:
  • Thank You Letter
  • Bio Form