Natalie Marc Surpris Scholarship Application 2025 Logo
  • All applications MUST be submitted by March 2, 2025

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  • What school do you currently attend?

  • Personal Essay: Please answer the following questions:

    1. What type of cancer diagnosis do you, your parent, or your legal guardian have?

    2. How long have you, your parent, or legal guardian been battling cancer?

    3. How has cancer affected your life and your family’s life?

    4. Knowing how cancer has a big impact on lives, how did you remain a model student?

    5. How will you utilize the scholarship fund to help with your academic journey?

    6. Please respond to the following prompt:

    If you could change any aspect of the cancer journey for yourself, your parent, or your legal guardian, what would it be and why?

    The essay should be written in a minimum of 1000 words.

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  • List of supporting documents:

    1. Proof that yourself, parent, or legal guardian has been diagnosed with cancer.

    2. Copy of birth certificate or court document showing proof of Legal Guardian

    3. Death Certificate (if applicable)

    4.  Proof of cancer treatment. All forms must be signed by the treating physician.

      Examples below:
      History of diagnosis and treatment with start and end date (if applicable). 
      Summary/Soap note from last appointment with an oncologist or treating physician, with history or present diagnosis/treatment with start and end date (if applicable).
    5. Proof you are a High school senior or College undergrad student(Verification of Enrollment)
    6. Unofficial Transcript to prove at least 3.0 GPA
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  • Statement of Accuracy

    I hereby affirm that all the above stated information provided by me is true and correct to the best of my knowledge. I also consent that my picture may be taken and used for any purpose deemed necessary to promote the Natalie Marc Surpris Scholarship Fund. I hereby understand that if chosen as a scholarship recipient, according to the Natalie Marc Surpris Scholarship  Fund policy, I must provide evidence of enrollment/registration at the college of my choice before scholarship funds can be awarded.

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  • Deadline: The application form and all other required documentation must

    be submitted by March 2, 2025. Any applications received after the

    deadline will NOT be considered. Please carefully review the Natalie

    Marc Surpris Scholarship Fund Policy/Guidelines for a complete list of

    documents required for eligibility. Please submit questions or concerns via email or phone to Gensen M. Surpris at:

    info@westandtogetherinc.org or 954-667-9336

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