Faculty Scholarship Chair  Sign-off

Bobby Hackett Jazz 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 CCRI's Fine Arts Program? Yes__ No__

2.   Is the selected recipient a music major? Yes__ No__

3.  Has the selected recipient completed six (6) credits of study in music? Yes__ No__

4.  Has preference been given to students enrolled in Jazz studies? Yes__ No__

5.  Has the selected recipient fully completed the application form? Yes__ No__

6.  Did the selected recipient submit his/her application on or before May 1? Yes__ No__

7.  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