Receipt Collection Form
Page 1
Please be sure to refer to your award letter from APIA Scholars for total award amounts and approved categories. All receipts submitted should reflect expenses you paid for the categories you were approved for. All receipts submitted should total the amount you were awarded as closely as possible.
First Name
Last Name
Date of Birth
Personal Email
College Email
Page 2
Which of our funding programs are you submitting a receipt for?
Scholar Relief Fund
Career Development Fund
Robert Underwood Scholarship
Page 3
How much were you approved for and received?
Please refer to your award letter with specific information on your total award and approved categories.
What categories of funds were you approved for?
Textbooks or School Fees
Housing
Utilities (electric/heat/water/internet)
Food Assistance (Receipts are not required for food assistance)
Childcare
Medical/Dental Costs
Transportation
Technology
Workplace Attire
[Multiple Choice] i.e. food assistance or housing
Please upload any receipts or proof of purchase demonstrating how you spent your APIA Scholar funds:
How many receipts do you need to upload?
Please select...
1
2
3
4
5
Upload Documentation 1
Documentation 1
Upload Documentation 2
Documentation 2
Upload Documentation 3
Documentation 3
Upload Documentation 4
Documentation 4
Upload Documentation 5
Documentation 5
Contact Information