Scholarship Renewal Form | Idaho Governor's Cup

If you are graduating, Congratulations! Please complete and submit this form.
(2019 – 2020)

Name

Last *

(last)

First *

(first)

Middle Intial

(middle initial)

Address

Number and Street

(number and street)

City

(city)

State

(state)

Zip Code

(zip code)

Student ID # *

Email *

Phone

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 30^th.

I intend to enroll Fall 2019

Institution

Institution Name *

Institution (city) *

(city)

Institution (state) *

(state)

Institution (zip) *

(zip)

Major

Anticipated Graduation Date

I do not intend to enroll in 2019 – 2020 due to one of the following:

Graduation

End of Eligibility

Requesting Leave of Absence or Suspension (Must submit letter explaining by January 30th due date)

Other (please explain)

Other

SELECTION CRITERIA

Current Grade Point Average *

Cumulative Grade Point Average *

Grade Level in Fall 2019

Grade

Freshman

Sophomore

Junior

Senior

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

Academic Highlight *