Scholarship Dinner Student Response

As a recipient of a donor-funded Penn State Fayette scholarship, you and up to two guests are invited to attend the 13th Annual Scholarship Donor Dinner at 5:30 p.m. on Wednesday, November 16 in the Café 65, Community Center.

Please submit this response form no later than Tuesday, November 1, whether or not you are able to attend.

Student Information

Student Last Name:

Student First Name:

Penn State Email:

Will you be attending?

Yes

Guest Information

Number of guests who will be joining you?

Student recipients attend free of charge; the cost for each guest is $25 and must be paid in advance by check made payable to “Penn State.”

Name of first guest:

Name of second guest:

Do you and/or your guests have any food allergies or dietary restrictions?

Yes

If yes, please indicate: