Attachment II


Financial Aid and Scholarships


Departmental Scholarship Transmittal Form



Complete and submit this form only if (please check one):


              This is a new scholarship account.

              This is a change to an existing scholarship account.



Scholarship Information



Scholarship Name


Contact Person for this Scholarship


Contact Phone Number


Contact Email


Cost Center #


Fund #


Development Fund Account # (if DF account)


Maximum Award Amount per Year


Minimum Award Amount per Year


Number of Awards per Academic Year (Fall and Spring)


Composition of Awarding Body







Minimum Texas State Cumulative GPA Required


Minimum Number of Hours Required per Semester









Please email this form to