The Stephen Phillips Memorial Scholarship Fund
Online Registration Form

Now that you have completed your application and are ready to mail it, you must register online, using the form below. Once you submit this registration form, you will receive an email with your Registration Number. Please write that number on the "ONLINE REGISTRATION NUMBER line on the top of Page 1 of the application. This unique identifier will allow us to match your paper application to your registration information.

Please enter your mailing address information, not your street address if they differ, as we will mail letters to all applicants in June with your status.

Also, please use standard capitalization (not all capitals or lower case please) and punctuation, as this information creates your application file. Correct registration data will reduce our data entry time and increase the accuracy of your application file.

Title:
First Name:
Last Name:
Mailing Address:
City:
State:
Zip Code:
E-Mail:
College you will attend:

College Year of Graduation:
College CEEB code:

Don’t know it? Click here: COLLEGE CEEB LOOK-UP
High School Attended/Attending:

High School CEEB code:

Don’t know it? Click here: HIGH SCHOOL CEEB LOOK-UP
Last four digits ONLY of your Social Security Number 
xxx-xx-
Birthdate: (MMDDYYYY)

   
Please register when your application is complete, and be sure to write your Registration Number on Page 1 of the application.
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