She MATHS 2026 Scholarship

Disbursement Form

First Name

Last Name

Phone Number

Address

Date of Birth

Name of College/University

STEM Major

Classification

Freshman

Sophomore

Junior

Senior

I prefer to receive my disbursement via

Only complete this section if you selected "Check"

Address where check should be mailed (if this is a dorm or apartment, please be sure to include the unit or apt#)

Only complete this section if you selected "Zelle"

All information collected will only be used for the electronic disbursement of funds.

Bank Name

First & Last Name on Account

Phone # or Email Associated with Zelle Account

Confirm Phone # or Email Associated with Zelle Account

Upload Student Enrollment Verification Showing Full Time Enrollment. Must be PDF file (you can typically request this from the registrar's office).

Upload your file

Choose a file or drag and drop one here.

Your Signature

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