Scholarship Recipient Form - La Crosse Community Foundation

Student recipients of a scholarship from a La Crosse Community Foundation scholarship fund must complete and submit this form to confirm a scholarship award and provide the information needed for payment purposes. This form is for new and renewing scholarships only.

Questions? Call Sherry at (608) 782-3223 ext. 21 or email sherry@laxcommfoundation.com.

Name:*
College Student ID#:*
Scholarship Received:*
Email:*
Phone Number:*
Current Address:*

Street, City, State, Zip Code
Parent's Email:*
High School Attended:*
College or University Attending:*
Upcoming Year in School:
- Freshman
- Sophomore
- Junior
- Senior
Address of College or University Attending (where to send payment):*
City:*
State:*
Zip Code:*
Your Major:*
Transcript/Schedule/Grades:*
Accepted file types: jpg, gif, bmp, doc, docx, pdf, Max. file size: 256 MB.
For new scholarship recipients, attach enrollment verification of college registration/unofficial transcript or a college class schedule that includes your name, your institution's name, and course load for the current semester. For renewals, also attach your an unofficial college transcript showing final grades from last semester and enrolled courses for the upcoming semester.
I understand that if I change my major or drop out of school or do anything that changes my status as a student at the above named school, college, or university in the major indicated, I will notify La Crosse Community Foundation immediately.*
- I understand.