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Scholarship
For Students
Apply now
Student Success Coordinators
Opportunity Grants
For Families
For Educators
Give
Volunteer
Programs
About
About Us
Impact
Partners
News & Resources
Contact
Donate
Apply
Returning Scholarship Recipient
Appeal Form
Please complete all questions on the form below to submit an appeal for review.
Returning Scholarship Recipient Appeal Form
First Name
M.I.
Last Name
Date of Birth
Month
Day
Year
High School
Graduation Date
Month
Day
Year
Street Address
City
State
Zip code
Email
Phone
GPA last semester you attended Simmons or Jefferson (if applicable) .
Are you in good academic standing to return to Jefferson or Simmons?
Yes
No
Please describe for us why you believe, you should be eligible to continue the Evolve502 scholarship? Note: Be sure to provide details.
Is there anything else you would like us to know or anything you can provide to us to help make our decision about your eligibility for the Evolve502 Scholarship?
Attachments
Please include any attachments that may support your appeal (doctor’s note, transcript, etc.) This is not required.
Drop files here or
Select files
Accepted file types: pdf, doc, jpg, Max. file size: 50 MB.