Outside Scholarship Reporting Form

Please complete this form to report any outside scholarship funding you will receive for educational purposes for St. Joseph’s College of Nursing for the 2019-2020 academic year.

Documentation must be attached to this form for any scholarships listed below to ensure they will appear as anticipated aid on your Bursar account.

*This form is required even if the scholarship funds are sent directly to the student.

Name Name First Last
Email
Program Option Accepted To:

Program Option Accepted To: Weekday 2YR Current Freshman at Le Moyne College - DDPN Evening/Weekend AD Evening/Weekend ADDPN
1. Outside Scholarships – high schools, foundations, companies, community organizations, etc.
Scholarship Award $ Dollars . Cents
2. Outside Scholarships – high schools, foundations, companies, community organizations, etc.
Scholarship Award $ Dollars . Cents
3. Outside Scholarships – high schools, foundations, companies, community organizations, etc.
Scholarship Award $ Dollars . Cents
Please submit proof of your outside scholarships (i.e. official statement from organization.

Attach Files
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Full Name

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Date Date / MM / DD YYYY
Non-Discriminatory Policy

St. Joseph’s College of Nursing at St. Joseph’s Hospital Health Hospital does not discriminate in the administration of educational policies or programs, admission policies, scholarship and loan programs, and other school-administered Programs. The College’s non-discrimination policy is inclusive of, but not limited to, race, age, color, national or ethnic origin, marital status, gender, sexual orientation, gender identity, gender expression, veteran/military status, religion, disability, or political ideology.
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