The Winnie & Frank Harvey Scholarship Textbook Reimbursement Application

Harvey College Textbook Reimbursement Program Application Form.
DEADLINE: MARCH 1
Applications received after March 1 will not be accepted. Highlight textbook expenses only on your receipts from the current school year.

Applicant's Name Applicant's Name First Last
Applicant's Address at College Applicant's Address at College
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Applicant's Phone Applicant's Phone - ### - ### ####
Name of Parent or Gurdian Name of Parent or Gurdian First Last
Home Address Home Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
College/University Attended
College/University Address College/University Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Dates Attended
ADDRESS TO WHICH CHECK SHOULD BE MAILED ADDRESS TO WHICH CHECK SHOULD BE MAILED
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Total Dollar Amount of Book Receipts Attached
Please Upload Scans or Pictures of Recipts (Highlight Textbook Expenses ONLY)
Please E-mail online receipts to ChristianEd@cpcab.org

Attach Files
How many Harvey Scholarship College Textbook Reimbursement awards have you already received (prior to this award)?
I am a member of Community Presbyterian Church and I certify that all information contained in this application is true, complete, and accurate.

Draw your signature below:

Draw or Type

I understand this is a legal representation of my signature. Clear

Full Name

I understand this is a legal representation of my signature.
Type Signature
Date Date / MM / DD YYYY