Application for Disbursement of MAOTeen Scholarship Funds

Completion of this form and the attachment of the necessary documentation are required for the payment of all scholarships. No exceptions will be made without the consent of the MAOTeen Scholarship Committee. Please allow 30 days from the receipt of all required documentation for payments to be processed and paid.

APPLICANT INFORMATION

Date of Application (MM/DD/YYYY) (required)

Date of HS Graduation (MM/DD/YYYY) (required)

Contestant Name (required)

Name of State Title and Year (required)

Address (required)

City (required)

State (required)

Zip (required)

Phone - Home (required)

Phone - Cell (required)

Email (required)

Parents’ Names (required)

Parents’ Address, City, State, and Zip (required)

Parent Phone - Home (required)

Parent Phone - Cell (required)

Parent Email (required)

Name of Your Teen State Executive Director (required)

Email Address of Your Teen State Executive Director (required)

List all scholarships (names/amounts) you won in your state while competing in ANY MAOTeen Preliminary:

COLLEGE/UNIVERSITY INFORMATION

Name of College or University (required)

Website Address of School (required)

Address, City, State and Zip (required)
*Note: Include the address for where the scholarship check is to be sent.

Name of Contact Person (required)

Phone of Contact Person (required)

Email of Contact Person (required)

Student ID Number (required)

THE FOLLOWING INFORMATION IS REQUIRED AND MUST BE ATTACHED TO THIS DOCUMENT:

1. Letter from contestant requesting payment of scholarship to her university/college.

2. Letter from State Pageant Executive Director verifying that all state and local scholarship monies have been exhausted, without forfeiting.

3. Original detailed and current copy of tuition bill, showing a balance due. (“Zero Balance” tuition statements are not accepted). Bill must show all other scholarship assistance. Bill must also be produced after the “ADD/DROP” date for each semester. (Refer to contract, Attachment B for further explanation of rules.)

4. (If applicable), a copy of “On Campus” housing bill. (Refer to contract, Attachment B for further explanation of rules.)

5. (If applicable), a copy of your student loan document with all instructions for payment of scholarship directly to the loan company.

6. Signed Family Educational Rights and Privacy Act of 1974 (FERPA) form (click here to download). This form must be on file at your school.

IT IS IMPORTANT THAT YOU REVIEW ATTACHMENT B OF THE NATIONAL CONTRACT FOR COMPLETE RULES AND REGULATIONS REGARDING THE PAYMENT OF SCHOLARSHIP FUNDS. THE NATIONAL CONTRACT HAS BEEN UPDATED TO BE COMPLIANT WITH CURRENT IRS RULES AND REGULATIONS REGARDING THE PAYMENT OF SCHOLARSHIPS.

BY CHECKING THE BOX BELOW, I AM AGREEING THAT I HAVE READ THIS DOCUMENT AND ATTACHMENT B OF THE CONTRACT. I UNDERSTAND THAT I MUST FOLLOW THESE INSTRUCTIONS AND THE RULES AND REGULATIONS FOUND IN THE NATIONAL CONTRACT REGARDING THE DISBURSEMENT OF ALL SCHOLARSHIPS. I ALSO AGREE THAT THE SCHOLARSHIP COMMITTEE WILL REVIEW ANY DISPUTE WHICH MAY ARISE CONCERNING THE PAYMENT OF SCHOLARSHIPS, AND THAT THEIR RESOLUTION SHALL BE THE FINAL WORD OF THE MAOTEEN ORGANIZATION.

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