Departmental Scholarship Receipt Form

It is the responsibility of the school/department to notify students about the receipt of scholarship awards.
All scholarship funds must be disbursed by the Financial Aid Office. Scholarship funds are applied directly to the student’s account. Funds cannot be processed through Accounts Payable or any other area. If you have any questions about how to process an award, please email Duski Hill dhill7@uncg.edu, Jacob Leonard jdleona3@uncg.edu, or Peri Lapp prlapp@uncg.edu.
If scholarship funds are disbursed in good faith to a student who subsequently becomes ineligible for the scholarship, the Financial Aid Office will not attempt to retrieve these funds from the student. Departments may do so at their discretion.
If students have questions about how their scholarship may affect their financial aid, please direct them to contact the Financial Aid Office at 336-334-5702 or email finaid@uncg.edu and a Financial Aid Counselor will assist them.
Please note: if a student has an existing financial aid award package, the scholarship award may result in the modification of the existing financial aid. Not all students will receive a refund because of being awarded a scholarship.

Please Read:*

I have read and understand the above statement

Awarding Department:*

Scholarship Name:*

Banner Fund Number:*

Banner Fund Code:

Student Full Name:*

*One name per sheet, please, as this form becomes a part of the student’s financial aid file.

Student ID Number:*

Award Amount Per Semester

FALL 2025:

SPRING 2026:

SUMMER 2026:

Note: Summer awards should not be submitted until after April 1st.

FALL 2026

SPRING 2027

SUMMER 2027

Note: Summer awards should not be submitted until after April 1st.

Authorization

Consent*

I, the undersigned, authorize the Financial Aid Office to make the award listed above and to allow the student access to the funds. This award is made in compliance with the terms of the fund’s Statement of Establishment (or restrictions of the donor, if there is no Statement of Establishment) and/or the established procedure of the school/department for selecting recipients, as acknowledged by the Financial Aid Office. I certify that this is not a student payment for work or other services rendered.

Authorized By:*

First Last

Email Address*

Date*