EnergySolutions Foundation

EnergySolutions Foundation Scholarship

Scholarship Funds Release Form

This is for Past Scholarship Recipients Who have been Accepted to a College or University

Congratulations on your award. We are happy to help with your education and career goals. When you have been accepted into the college you will be attending and have a complete high school transcript, please fill out this information and send transcripts it to the Foundation. Please allow for at least six weeks for processing and note that Scholarship Funds will be released until a transcript from your high school for your 10^th, 11^th, and 12^th grades have been received by to verify that you met the 3.5 GPA requirement. Please wait until you graduate and send one complete transcript.

Mail your transcript to:
EnergySolutions Foundation
PO Box 510583
Salt Lake City, Utah 84101

Please complete the following. All fields are required:

First Name
Last Name
Email
Date of Birth	/ /
State
High School Attended
(If you moved during your junior or senior year please list the high school you attended when you received the scholarship)
Year You Received Scholarship
Major Declared
Other Major

UNIVERSITY/COLLEGE INFORMATION
University/College Name
Address
City	State Zip

UNIVERSITY/COLLEGE FINANCIAL AID INFORMATION
Address
City	State Zip
Phone Number
College/University Deadline Month	Day
(This is the date that your scholarship must be in your account by)

DEFERMENT If you will not be attending college Fall 2009 semester or if you do not need the funds for this upcoming school year, please fill out the below portion. (Please note that if it is easier on you to send in your high school transcript now, we will be happy to keep it on file.)
Reason for Deferment
Expected College Start Date or anticipated date funds will be needed