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In Memory of Leo M. Haskins, Jr.
In Memory of Brian K. Duffey
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Menu
About Us
By the Numbers
History
Unsolved Mystery: The George Snow Story
Meet the Team
Board of Trustees & PAC
Policy Statements
Contact Us
Donors
Create an Annual Scholarship
Create an Endowment
Financials
Memorial Sites
Donor Bill of Rights
Giving Societies
Founders Society
Loyalty Society
Scholars Council
Policy Statements
Scholarships
FAQ
High School Scholarships
Palm Health Foundation Scholarships
Graduate Scholarships
Selection Process
Scholar Resources
GradSnapp Requirements
Benefactor Listing
Funding Documents
Support Services
Alumni Resources
Events
Boca’s Ballroom Battle
Drive Through Awards Presentation
Day with Bernhard Langer
The “Rhinestone” Cowboy Ball
News
Donate
Donate Now
Mind Over Matter Mental Health Awareness Scholarship
Melissa Krupp Memorial Scholarship
In Memory of Leo M. Haskins, Jr.
In Memory of Brian K. Duffey
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Funding Document:
The following form is for Admirals Cove & Polo Club Scholars ONLY.
Please complete the following questionnaire. We will not process any request for funds unless all requested information is supplied.
Please select the appropriate statement:
This Semester....
*
I WILL be taking a disbursement this semester.
I WILL NOT be taking a disbursement this semester
First Name:
*
Last Name:
*
Email Address:
*
Cell Phone:
*
Home Phone:
Home Address:
*
Address Line 2:
City:
*
State/Province:
*
Zip Code:
*
School You Are Attending:
*
Where do you plan to live during the school year?
*
On Campus Housing
Off Campus Housing
Live With Parents
What is your best mailing address while in school?
Street Address
*
Apartment, Suite, or Mailbox #:
*
City
*
State:
*
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
American Samoa
Federated States of Micronesia
Guam
Marshall Islands
Northern Mariana Islands
Palau
Puerto Rico
U.S. Minor Outlying Islands
Virgin Islands
Armed Forces Americas
Armed Forces Europe, the Middle East, an
Armed Forces Pacific
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland and Labrador
Nova Scotia
Northwest Territories
Nunavat Territory
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon Territory
Zip
*
Are you employed while at school?
*
Yes
No
If yes, provide name of employer and number of hours per week.
List any memberships in school or professional organizations.
List any honors or awards you have received since high school graduation.
List any other scholarship you have received (this will not affect your Snow Scholarship)
Has your family's financial situation changed since you have been awarded this scholarship?
*
Yes
No
If yes, please explain.
Parents names and names of their employers.
*
Major
*
Current Cumulative Grade Point Average
*
Total credited hours completed
*
Current Status
*
Freshman
Sophomore
Junior
Senior
Questions/Comments: Is there anything you would like to let the staff of The George Snow Scholarship Fund know?
Student ID #
*
Year you received a George Snow Scholarship.
*
Scholar's Affidavit
“Internal Revenue regulations require that your scholarship grant be used for qualified tuition and related expenses in order for it not to be taxable income to you. Qualified tuition and related expenses consist of tuition, fees, books, supplies, and equipment required for the courses of instruction at an educational organization. Examples of expenses that are not qualified tuition expenses are room and board and other general expenses. We suggest that you consult with a tax specialist to determine the tax consequences of your grant.”
I have read and understand the above statement and attest that these funds will be used accordingly. Failure to do so will result in forfeiture of any additional funds.
Date of Request
*
I have read and agree to the above statement
*
Yes
No
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