Scholarship Donor Questionnaire "*" indicates required fields Please respond to the following items and mark your preference.1. Scholarship Title/Name*2. Award Criteriaa) Minimum Grade Point Average (GPA):* 4.0 GPA (A) 3.5 GPA (B+) 3.0 GPA (B) 2.5 GPA (C+) 2.0 GPA (C) b) Must have Financial Need:* Yes No c) Declared Major or Career Goal:*d) Other Criteria (if any):e) College status:* Entering (prospective student coming to Palomar College) Returning to Palomar College Transferring to a 4-year college No Preference 3. Selection Processa) All scholarship recipients are selected by the Palomar College Scholarship Committee. This prestigious and dedicated group is comprised of Palomar College faculty and administrative members. However, you may request a certain Palomar College department to make the selection. Please indicate your choice below.* Palomar College Scholarship Committee selects recipient Specific Palomar College department selects recipient* (see next question) b) If Specific Palomar College department selects recipients, indicate name of department and contact person:3. Award DisbursementAll scholarships are advertised and recipients are selected in the spring semester. Unless indicated, scholarships are paid or made available to recipients in the following fall semester. In addition, if the total scholarship award is over $500, the award will be paid in two installments, ½ in the fall semester and ½ in the following spring semester.a) At time of disbursement, recipient must be enrolled:* Full-Time (at least 12 units) 3/4 Time (9-11 units) Part-Time (less than 9 units) b) At time of disbursement, recipient must have a continuing GPA of:* 4.0 GPA (A) 3.5 GPA (B+) 3.0 GPA (B) 2.5 GPA (C+) 2.0 GPA (C) 4. Award Funding Status* Awarded Annually Endowment (only interest/gains earned may be awarded) a) If annual award - list amount of award and number of awards*b) If endowment - list amount of endowment upon establishment of corpus and preferred number of awards*5. Other preferences or comments6. Donor ContactName of Organization:Person's Name* First Last Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone*Email* Δ Image Sources Foundation Logo: Palomar College Foundation
