LCC Foundation Scholarship Confirmation Form

You can find the scholarship name and ID# on the Scholarships Awarded page. Enter the scholarship name and ID# listed next to your name. If you receive more than one scholarship, you must complete a separate online Scholarship Confirmation Form for each award.

Scholarship ID# *

Name of Scholarship Awarded *

Scholarships may be used at Lane Community College and are not transferable to any other institution. Enrollment required for each scholarship and eligibility will be verified each term before any awards are made. Most scholarships require full-time enrollment. There are no scholarships available for students enrolled less than part-time.

Will you be a student at Lane Community College in the fall?

Yes

No

What is your academic major? *

Last Name: *

First name: *

Middle name: *

Student L# *

Email Address: *

I understand I must successfully complete the enrollment requirement(s) listed next to my scholarship name and ID# to maintain my scholarship. Students who do not enroll at Lane in fall term will no longer be eligible for their scholarship. Some scholarships are dependent on acceptance into a specific program. I must also maintain a minimum 2.0 or higher grade point average for each term and maintain satisfactory academic progress to maintain the scholarship. I understand that some donors will want to meet their recipient/s either at a Foundation event or in a personal meeting arranged by Foundation staff (you will be notified well in advance of such an event/meeting). If you cannot participate in such an event/meeting when requested, please discuss your personal situation with the Foundation's Scholarship Coordinator.

Scholarship Choice *

I accept this scholarship under the terms listed above.

I decline this scholarship offer.

Please Confirm *

Accept Scholarship

Declined Scholarship

YOU HAVE DECLINED YOUR SCHOLARSHIP OFFER

Mailing Address *

City *

State *

Zip Code *

Preferred Phone Number *

(555)555-5555

Thank you to Your Scholarship Donor (Paragraph #1 of 3) *

Your scholarship is possible because someone cares about your education and your dreams for the future. Include a statement thanking this donor for the scholarship (use the name of the scholarship in the sentence). Let them know why this scholarship is important to you and your education. Tell them how your opportunity to attend college has affected your life and your family.

Thank you (Paragraph #2 of 3) *

Tell the donor a little bit about yourself and your program of study. State your future career plans and goals and how you will use your education/degree (go to work immediately after graduation or transfer to a University, etc).

Thank you (Paragraph #3 of 3) *

Write a few final words of thanks to the donor of your scholarship.

Optional Volunteer Opportunities

Scholarship recipients often ask what they can do to express their gratitude for the financial support and generosity they have received. The Foundation welcomes students to help us with some of our special activities. We will contact you during the year to let you know what volunteer opportunities are available. An hour or more of your time can make a big difference. Thank you!

Authorization to Share *

If I am awarded a scholarship, I hereby give approval for Lane Community College to publicize any scholarship award I receive, listing my name, hometown, name and amount of the scholarship, and biographical summary. I authorize Lane Community College to share copies of my thank you responses, excerpts of application essays, college major and degree with my scholarship’s donors. I authorize the Foundation Office to access my academic and financial data to verify scholarship eligibility. Further, unless a written statement to the contrary is filed with the Foundation Office, all scholarship recipients give authorization to the LCC Foundation and Lane Community College to publish photographs of themselves for promotional purposes. If you have privacy concerns, please address these concerns with the Scholarship Coordinator prior to accepting this scholarship.