Megan & Alex Bean Educational Opportunity Fund Winner's Submission

Scholarship Release Form

Student Name. (First and Last)*

Email.*

Please attach a recent photograph of yourself (taken within the last 6 months); a digital picture in a .png or .jpg format is preferred.*

Max. file size: 32 MB.

Please attach a copy of your most recent report card or grade transcript.*

Max. file size: 32 MB.

Financial Aid Office Contact Form

Student ID*

School Name*

Financial aid office contact name*

Financial aid office phone number*

Financial aid officer email*

Tuition dollar amount after financial aid.*

A copy of your tuition bill (reflecting the balance after any other tuition scholarships may have been awarded).*

Max. file size: 32 MB.

Consent

Consent*

By clicking this box, you are granting the Partner (as defined in the scholarship notification rules) permission to announce you as one of the winners of the scholarship program, as well as permission to use your name, image, and excerpts of your application.

I grant permission to the Partner (as defined in the scholarship notification rules), EducationDynamics, LLC, and its related companies, as well as its employees, officers, directors, and agents, to use and publish my name, photograph, and excerpts from my scholarship application answers in connection with publicity and promotion of any Scholarship Programs, services, and websites, or any other promotion, contest or sweepstakes sponsored by the Partner, EducationDynamics, LLC, and its related companies. This includes potential publication of my name, images or likeness or application excerpts, or features about myself, in any worldwide media, including: (1) brochures; (2) on websites; (3) on social media (4) press releases; or (5) on other promotional and advertising materials. Whether to include my information in any publication, publicity or feature is at the sole discretion of the Partner, EducationDynamics, LLC, and its related companies, and I agree to hold the Partner, EducationDynamics, LLC, and its related companies harmless for any damages relating hereto.

Consent*

This is confirmation that I am over the age of 18.

This confirms that I am NOT over the age of 18.

Parent/Guardian Name*

First Last

Parent/Guardian work location*

Parent/Guardian email*

Parent/Guardian Phone*

Parent consent*

Parent or legal guardian agrees to the following statement: I consent to this Scholarship Release Form.

This field is for validation purposes and should be left unchanged.

Congratulations again on being selected as a Megan & Alex Bean Educational Opportunity Fund winner!

Scholarship Release Form

Financial Aid Office Contact Form

Consent