Scholarship Transfer Form

Today's date*
DD slash MM slash YYYY
Personal Information
Your Name*
First Last
Your HOME ADDRESS*
Street Address City State ZIP Code
Contact Phone Number*
Your Social Security Number*
School/Career Center*
This should be where you are a HOSA Member
Scholarship Information
The name of the scholarship(s) you received.*
The amount of the scholarship received.*
Where was your Thank You letter sent?*
When did you send your "Thank You" Letter?*
DD slash MM slash YYYY
College Information
Name of your University/College/Training Program*
University/College/Training Program Address*
Street Address Line 2 City State Zip
The name of the Financial Officer at your University/College/Training Program (if available)
Financial Office Phone Number*
Date scholarship funds need to be paid.*
MM slash DD slash YYYY
Additional Financial Aid*
If you have additional financial aid, would you like the school to verify that this scholarship will not change your eligibility for the other aid?
- Yes
- No
Upload a copy of your acceptance letter.*
Accepted file types: pdf, Max. file size: 50 MB.
Comments
CAPTCHA

PLEASE NOTE:

A check from SC HOSA will be sent directly to the student’s university, college or training program
Prior to submitting your scholarship transfer fund form (below), please send a thank you note to your scholarship donor(s) listed in your award letter (you should have received via email)
Any unused HOSA scholarship monies will be returned to SC HOSA, Inc
A letter of acceptance from the student’s university/college/training program must be uploaded in the form below and kept on file with SC HOSA
SC HOSA will hold your funds, up to three (3) years, should you not need the money for the next school year
Do NOT contact the scholarship donor(s) to request these funds. Partners/donors have donated funds to SC HOSA for distribution to scholarship award winners