Survey of Faculty Regarding Diversity Scholarship InformationIf you have more than one student at your site, please fill out a form for each student.Your Name* First Last Your Email* Student Name* First Last Contextual Education Site* Academic Period*Full Academic YearFall SemesterSpring SemesterSummer 1 (student is engaging in ~12hrs/wk of on-site internship hours)Summer 1 and 2 (student is engaging in ~24hrs/wk of on-site internship hours)Payment InformationThe scholarship payment will be due at the start of each semester to the Contextual Education Office. Please make checks payable to Boston University School of Theology with the student's name on the check in the memo line. Please mail checks to the following address: Contextual Education Office Boston University School of Theology 745 Commonwealth Avenue, Suite 107 Boston, MA 02215 Choose One Option*Please see note above re: instructions. Our site will contribute the full $1500 per semester scholarship for our intern. Our site would like to contribute more than the minimum $1500 per semester scholarship for our intern. Our site is unable to contribute the full $1500 per semester, but we are able to contribute a portion. Our site is unable to contribute toward the student’s scholarship at this time. Our site already provides the student a salary or other funding which is paid to them directly and meets or exceeds $3000 per semester. Therefore, we will not be sending student funding through the School of Theology. If allocating over $1500 per semester, please provide amount per semester:If contributing a portion of the scholarship, please provide amount:If contributing a portion of the scholarship, please indicate when will this contribution be made. Per academic year Per semester ShareClick to email this to a friend (Opens in new window)Click to share on LinkedIn (Opens in new window) View all posts
