ROCKFORD PROMISE
SCHOLARSHIP APPLICATION FORM
FOR ROCKFORD UNIVERSITY

(Must be submitted to Rockford Promise by January 11, 2019)

I, a Rockford School District 205 student eligible for graduation in 2019, am requesting a Rockford Promise scholarship.  I understand to be considered for enrollment in Rockford University under this scholarship program, I must be both PELL and MAP eligible.  (You must apply to Rockford University before you submit this application.)

Personal Information
Name *
Name
Date of Birth *
Date of Birth
Address *
Address
Phone *
Phone
Choose one
Choose One
Scholarship Eligibility Requirements
I understand that, in order to be eligible for a Rockford Promise scholarship, I must meet the following requirement PRIOR to submitting the application:
1 - FAFSA *
My Expected Family Contribution is: If your Expected Family Contribution (EFC) is not available, explain why (i.e. immigration status, incomplete FAFSA, etc.)
2 - GPA *
3 - Applied to the school *
4 - SAT *
5 - PELL *
6 - MAP *
Additional Required Information
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Optional Additional Information
List all:
List all:
Scope of Scholarship
I understand that, if I am selected for a Rockford Promise scholarship and I am admitted into Rockford University, Rockford Promise will fund a tuition grant to Rockford University on my behalf. This tuition grant will be paid to Rockford University each year for a maximum of four (4) years, with each yearly distribution equal to the in-district cost of 32 credit hours at Rock Valley College. For example, if the Rock Valley credit hour rate is $125, Rockford Promise will provide 32 credit hours X $125 = $4,000 to Rockford University. BY ELECTRONICALLY SIGNING THIS APPLICATION, I AUTHORIZE ROCKFORD PROMISE TO VERIFY MY EDUCATION, GRADE POINT AVERAGE, AND EXPECTED FAMILY CONTRIBUTION (EFC) BY REQUESTING AND RECEIVING A COPY OF MY ROCKFORD SCHOOL DISTRICT 205 TRANSCRIPTS, A COPY OF MY STUDENT AID REPORT (SAR), AND FINANCIAL AID INFORMATION FROM ROCKFORD UNIVERSITY.
Student's Verification
My electronic signature below indicates that I have read and understand the terms of the Rockford Promise scholarship and that the information I have provided is true to the best of my knowledge. I further understand that my electronic signature below allows Rockford Promise to access my Rockford Public School District 205 transcripts, my Student Aid Report (SAR) including my Expected Family Contribution (EFC), and my Rockford University Application for the limited purpose of verifying my education and financial information.
Type your name below:
(Have Parent / Guardian Type their Name - Only Required if Student is under 18 Years of Age)