2023/2024 CONTINUING SCHOLARSHIP QUESTIONNAIRE RENEWAL FORM

Continuing Student Process for Current Bill Dickey Scholarship Association [BDSA] Students

STOP! Please read the following Scholarship Guidelines to ensure you comply!
Definition of Continuing Student: A BDSA full-time student in an accredited college or university that became a scholarship recipient their freshman year in college. If this applies, feel free to complete the form and submit it online.

Please complete the form below and answer all questions. Be sure to review your responses prior to clicking submit. This form can not be saved to complete at a later time.
    • Bill Dickey scholars are eligible to receive a scholarship on an annual basis up to four consecutive years, commencing with their freshman year of college
    • If an extenuating circumstance occurs; for example, the student has an illness and requires a scholarship extension, then he or she would have to provide documentation and submit their request to the Scholarship Committee for review, the decision will be made on a case-by-case basis.

BDSA Scholarship Guidelines:

    • Scholarship recipients are required to maintain a 2.5 GPA each semester and on a cumulative basis that he or she is enrolled in school
    • It is the scholarship recipient’s responsibility to submit this form each year to confirm the school they will attend and also to indicate what their scholarship funds will be used for during the current school year
    • If changes occur before or during that school year, a new form must be completed
    • Example: The scholarship will be utilized for room and board for the 2023-2024 school year
    • This renewal is due by the end of the Spring Semester, no later than June 16, 2023
    • The scholarship renewal form will be housed on the website under scholarships for students to access and submit
    • Scholarship recipients are required to submit their official transcripts 30 days after the semester ends
    • Transcripts must be mailed [certified] to the BDSA office, no emails accepted
    • Failure to comply with the scholarship guidelines could result in forfeiture of your scholarship

THE BDSA WILL NOT MAIL QUESTIONNIARES AND/OR SEND EMAILS REQUESTING YOUR TRANSCRIPTS. It is the student’s responsibility to comply with the guidelines.

Reminder: Setup reminders on your computer to ensure you meet the 30 day deadline [after each semester] to mail your transcript

Should you have questions and or require further assistance, please contact the BDSA office at 602-258-7851.

    STUDENT INFORMATION

    FIRST NAME *

    MIDDLE NAME *

    LAST NAME *

    SOCIAL SECURITY # (LAST 4 DIGITS) *

    ADDRESS *

    CITY *

    STATE *

    ZIP *

    EMAIL ADDRESS *

    MOBILE PHONE *

    DATE OF BIRTH *

    COLLEGE RECEIVING FUNDS *

    ATTN TO WHOM *

    COLLEGE ADDRESS *

    COLLEGE CITY *

    COLLEGE STATE *

    COLLEGE ZIP *

    STUDENT ID *

    WILL YOU ATTEND COLLEGE ON A SCHOLARSHIP? *

    yesno

    IF YES, WHAT DOES YOUR SCHOLARSHIP COVER? (BOOKS, TUITION, ROOM AND BOARD, OTHER) *

    HOW WILL YOU UTILIZE THE BDSA SCHOLARSHIP?(BOOKS, TUITION, ROOM AND BOARD, OTHER) *

    DO WE NEED TO SPECIFY ON THE CHECK HOW THE FUNDS ARE TO BE UTILIZED? *

    yesno

    INDICATE WHAT YOU WOULD LIKE LISTED IN THE COMMENT SECTION ON THE CHECK

    WITH WHAT MAJOR WILL YOU GRADUATE?

    WHEN IS YOUR EXPECTED GRADUATION?