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"Alternate Recipient" Contact Information

"Alternate Recipient" Contact Information

Please submit this form so that we can contact you if the primary scholarship recipient is unable to accept the scholarship. The scholarship can be held no longer than the end of the first quarter or semester of the second year after graduation from high school (Fall 2018).

Funds will be released to the institution in your name upon receipt of proof of registration including a student ID number.  Submit proof of registration to Franklin Pierce Foundation, 315 129th St. S, Tacoma, WA 98444 or fpfoundation402@gmail.com.

Note: Unless specified as "OPTIONAL," all fields require an answer.

Scholarship Name:

Your Name:

Mailing Address:

City: State:

Zip:

Cell Phone:

Home Phone (OPTIONAL):

Email:

High School Attended:

If known, school you plan to attend (OPTIONAL):

Major(s) or Area(s) of study (OPTIONAL):

Parent/Guardian Name:

Parent/Guardian Phone Number:

Parent/Guardian Email:

 



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