Student Status Form

At the end of each semester return your Student Status Form (download form or complete the form below) along with your transcript or grade report including current cumulative GPA, to the attention of the Program Associate utilizing any of the options listed below. Or complete the form online using the form below.

Margaret Brinkworth
4108 Charlestown Road, New Albany, IN 47150
Fax: (812) 948-4678 or email to mbrinkworth@cfsouthernindiana.com

Student Status Form

Name*
First Last
Date
MM slash DD slash YYYY
Scholarship received from CFSI and year awarded:
Email*
High School graduated from and year of graduation:
Name of college attending next year:
School address next semester:
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Your address while at school next year:
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Home/Parents address:
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Your cell phone #:
Parent's phone #
Your home phone#:
Academic Major:
Employer and hours per week:
Extra Curricular/Volunteer Activities:
Plans following graduation:
Attach Copy of Official Transcript:*
Max. file size: 32 MB.

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Student Status Form

Student Status Form

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