Scholarship Agreement

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First Name

Last Name

Name of Scholarship (s)

Fall 2024 enrollment will be

Full Time
Part Time
Less than 6 units

Fall 2024 I will be

Attending SBVC
Transferring

Spring 2025 enrollment will be

Full Time
Part Time
Less than 6 units

Spring 2025 I will be

Attending SBVC
Transferring

My Student Email

My Student ID#

My Phone Number

My Alternate Email

My Major

I understand and certify that I meet the scholarship criteria described to me, in order to receive funds for this scholarship and I must provide all proof required to establish eligibility.

I understand that I must submit a thank you letter addressed “Dear Scholarship Administrator” to the SBVC Foundation Office, by Monday, May 6, 2024.

I plan on attending the Annual Scholarship Ceremony on Tuesday, May 7th at 6pm in the SBVC Auditorium.

For questions regarding the process, please contact the Foundation Office at sbvcfoundation@valleycollege.edu or call
(909) 384-4471.

Signature

Please print your full name

*Date

San Bernardino Community College District does not discriminate on the basis of age, color, creed, religion, disability, marital status, veteran status, national origin, race, sex, sexual orientation, gender identity or gender expression. Complaint Procedure

701 South Mount Vernon Avenue, San Bernardino, CA 92410

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