High School Scholarship Online Submission Form

Congratulations on your scholarship achievement! You have helped your students discover that they can, and do, make a difference in our community. Please read the below instructions carefully.

Submission Form Instructions: Since your scholarships can be divided into multiples of $250 and awarded to one or more students, an authorized representative of the participating school must complete and submit a seperate form for each individual student recipient. All data fields must be completed, including the scholarship code, which can be found on the Red Cross scholarship letter that was mailed to you. If you have questions, please contact Portia Bradley at 216-426-7286.

Scholarship Code: : *

Scholarship Amount: * $

First Name: *

Scholarship Recipient

Last Name: *

Scholarship Recipient

Address: *

Scholarship recipient's address

City: *

State: *

Zip: *

Phone: *

Email address: *

Institution of Higher Education Attending: *

Name of the college, university or other institution of higher learning the student will be attending.

Institution Phone Number: *

Institution Address: *

Institution Address 2:

Institution City: *

Institution State: *

Institution Zip: *

Name of Participating High School: *

High School Phone: *

Name of Official Submitting Form: *

School Official's Email Address: *

High School Scholarship Online Submission Form

Local Red Cross Blood Services