2009 Scholarship Donations

2009 Scholarship Donation Form
Please fax completed form to Society Relations at 434-951-5322
Or send by email to [email protected]
Thank you for your willingness to donate scholarships for another society who has an increased
need. Please provide the following information by 15 January 2009:
Society Name:
Society Contact Name:
# of Scholarships Donated:
So that we may understand each societies need for scholarships, please select the options that
best describe your situation.

No local colleges/universities
Decreased demand from local students
No time for a selection process
Other: _____________________________________________________
Scholarship donations are allocated to other societies from your region. If you wish to donate
scholarships to a specific region, please indicate below:

Asia Pacific
Eastern US/New York
Midwestern US
Western US
SC US, Latin, & South America
SE US and Caribbean
Once your donation has been received, we will send you a confirmation e-mail of the total
scholarships you will have available for the 2009 fiscal year only. Please be aware that this
donation is final and cannot be amended.
Please let us know if you have any questions, comments, or suggestions.
Society Relations