Richard N. Davis Scholarship Interest Form

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Please complete the following Interest Form for the Richard N. Davis Minority Business Scholarship:

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Company

Brief description of your business:

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Atrium Health Wake Forest Baptist • Novant Health • Reynolds American • Truist • Wells Fargo

Bethany Medical • Cook Medical • Forsyth County • Front Street Capital • Hanesbrands, Inc. • Kelly Office Solutions • Kilpatrick Townsend & Stockton, LLP • Truliant Federal Credit Union • Twin City Development Foundation • Winston-Salem/Forsyth County Schools • Womble Bond Dickinson (US) LLP

525 Vine Street, Suite 240

Winston-Salem, NC 27101

T: 336-728-9200 E: [email protected]

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