Scholarship Reporting (school/institution use only) Scholarship Grant Report Organization Name:* Scholarship Fund Name:* Grant Amount:* Grant Date:* Grant Number: Contact Person:* Contact Email:* Name of scholarship recipient(s), including amount awarded, declared major and school email address for each student:*Date scholarship funds were disbursed to student account(s):* Were all of the grant funds disbursed?* Yes No I certify that the selection of the recipient was done in an open, fair and equitable process; that no member of any recipient's immediate family participated in the selection process; and that the criteria for the scholarship, as determined by the donor, was fully met.* Yes No Signature:*