Severely Injured Service Member and Spouse Scholarship Opportunities

Educational Institutions
If your institution has established one or more scholarships for severely wounded service members or for members of their families, please provide us with the following information.

For technical assistance for this form email ITHelpDesk@navy.mil.

Information about your Educational Institution

* Denotes fields that will show up on the public Scholarship detail's page
** Indicates mandatory fields.

* Name of Educational Institution:
**

Address:

City:

* State:
**

ZIP:

Type of Educational Institution (Check all that apply):

Occupational
School

Vocational
School

2 Year
School

4 Year
School

Graduate
School

Is your Educational Institution a Servicemembers Opportunity College (SOC) Member?
Yes No

Accreditation Status: Schools must be accredited by an accrediting agency or state approval agency recognized by the U.S. Secretary of Education.

Is your institution accredited with a nationally recognized accrediting agency?
Yes	No	If yes, which one?

Is your institution accredited with a regional institutional accrediting agency?
Yes	No	If yes, which one?

Scholarship Information

Name of Scholarship:

Narrative Description:

Length of Educational period.

Delivery Mode (Check all that apply):

Distance/Online

Traditional/Classroom

Course of Study:
[Enter "All" if no
specific course of study]

Who is eligible for this scholarship?

Severely Wounded Service Members

Spouses of Severely Wounded Service Members

Children or Other Family Members (e.g. Parents) of Wounded Service Members

Dependents of Service Members Who Have Been Killed In Action

Number of Scholarships available:

Scholarship Amount:

Anticipated Start Date:

Date:

Frequency of Scholarship:

One Time Offer

Annually

Unknown

Scholarship can be used for:
[Tuition, lab, fees, books, housing, etc.]

* Detailed scholarship information online at:

* School Admissions information online at:

* Educational Institution website:
**

* Educational Institution Email address:
**

* Point of Contact for scholarship information:
**

Point of Contact Email address:
**

* Must be an email address for the individual named as the Point of Contact - not an email address for an institution.

At what URL will scholarship information be available online and on what date?
	Date:

Return To DANTES Home