SAVANNAH STATE UNIVERSITY FOUNDATION, INC.
P. O. Box 20439
Savannah, Georgia 31404
Scholarship Reply Form
(FOR PREVIOUS SSU FOUNDATION SCHOLARSHIP RECIPIENTS ONLY)
*Please return this reply form with an Official Transcript and a Personal Photo (wallet size) for
publishing in our publications. Refer to descriptions and criteria in Scholarship Brochure.
Student Name ______________________________________________________________________________
Last
First
Middle Initial
Address __________________________________________________________________________________
City _____________________________________ State ____________ Zip Code _______________________
Home Phone # ( ) _________________________Cell # ( ) ______________________________________
Email Address: _____________________________________________________________________________
__________________________________________________________________________________________
Parent(s)/Guardian(s) Name(s) ________________________________________________________________
Address (If Different) _______________________________________________________________________
City _____________________________________ State ____________ Zip Code _______________________
Phone Number(s) (If Different) ________________________________________________________________
University ID or Social Security Number (SSN) ___________________________________________________
Name/Address of College Enrolled_____________________________________________________________
_________________________________________________________________________________________
Date Enrolled______________________________________________________________________________
Proposed Major (Course of Study) _____________________________________________________________
High School/University Grade Point Average (GPA) _______________________________________________
University Phone # _______________________________ Student Phone # ____________________________
Student’s University Address _________________________________________________________________
__________________________________________________________________________________________
Please sign your name on the appropriate line(s).
Yes, I will join Pre-Alumni ___________________________________________________________________
No, I will not join Pre-Alumni _________________________________________________________________
Yes, I will accept the Scholarship ______________________________________________________________
No, I will not accept the Scholarship ____________________________________________________________
Check Scholarship you are applying for: Varnetta Frazier Memorial GYF, Inc.(Eloise Mosley Young
Memorial) Henton Thomas Memorial SSUNAA-DC Chapter Annette K. Brock Maceo Taylor
Memorial Basketball Jimmy Colson Memorial Regent Emeritus Elridge McMillan John McGlockton
Memorial NROTC James O. Thomas, Jr. Leadership Dr. Margaret C. Robinson SSU Class of 1973
PLEASE RETURN COMPLETED FORM BY MARCH 31 TO:
Virginia J. Morrison, Ed.D.
Savannah State University Foundation, Inc.
Scholarship Fund Committee Chairperson
132 Hampstead Avenue
Savannah, GA 31405