The Raleigh Chapter of Chums, Incorporated
P.O. Box 28977
Raleigh, North Carolina 27611-8977
Chums Incorporated Founders National Scholarship
Thank you for your interest in the Chums’ Founders’ National Scholarship,
which was created to honor the people who founded our Organization and to
benefit young adults attending college for the first time who have
documented financial need. The CHUMS Founders’ National Scholarship is
a one-time scholarship award for the recipient
2017 Scholarship Interest Form
Please Print Legibly
Name: __________________________________________________________________
Address: ________________________________________________________________
________________________________________________________________
Parent/Guardian Name:_____________________________________________________
Contact Numbers:_________________________________________________________
Home:_________________________
Cell: _________________________
E-Mail Address: _________________________________________________________
Name of School: _________________________________________________________
Guidance Counselor/Career Counselor’s Name: _________________________________
Contact Number:_________________
Signature:_______________________________________________________________
Parent/Guardian Signature:__________________________________________________
Date:___________________________________________________________________
Questions:
Shirley Wilkins-Nimmons, Scholarship Committee Chair
919-772-3644 or [email protected]