Dare to Excel Donor Directive Form                 

I would like to award___________ # of Scholarships in the amount of $______________each.

                                                                                                                        ($500.00 minimum)                       

I would also like to sponsor ________ lunches at $20 each for students and faculty

____A representative(s) donating the scholarship will be attending the awards luncheon

____A representative will not be able to attend the awards luncheon

Name_______________________________ 

Company________________________________________________________

Address ________________________________________________________

            _________________________________________________________

Phone ________________________________ email:______________________________

Please recognize the Scholarship(s) as:

 _________________________________________________________

(example: John Brown memorial scholarship or Rotary scholarship)

I (we) would like for our scholarship(s) to be directed to one or more of the following:

______Applicant(s) chosen by the Dare to Excel Committee

_____ Directed to students interested in ___________________________field of study

_____ Directed to students attending  _____________________________________ 

                                                                             college, university, or trade school

_____ Other (please specify)

__________________________________________________________________

__________________________________________________________________

       The Dare to Excel Committee will do their best to fulfill your request