Scholarship Renewal Form

If you are graduating, Congratulations!  Please complete and return this form.
(2018 – 2019)

Name
(last)
(first)
(middle initial)
Address
(number and street)
(city)
(state)
(zip code)

The Governor’s Cup Scholarship Program rules require recipients to annually file a statement of intent to continue as a full-time undergraduate student.  Please complete this questionnaire and return it to the program manager no later than January 30th.

Institution
(city)
(state)
(zip)

SELECTION CRITERIA

Grade Level in Fall 2018
Recipient’s Signature
Date

Send completed form to: 
Sarah Bettwieser, Executive Director
Idaho Governor’s Cup Scholarship Fund, Inc.
PO Box 983
Boise, ID  83701 
sarah@idahogovernorscup.org
208-713-9466

Please include a paragraph below highlighting your college experience and accomplishments. We will use these updates when promoting our scholarship program.