ALG Scholarship Application

Andrew's Laughing Gas Scholarship Application Form

Helping future Child Life Specialists make a difference
Thank you for your interest in the Andrew's Laughing Gas (ALG) Certified Child Life Specialist Scholarship. Child Life Specialists played an important role in Andrew's life during the eight months he bravely fought leukemia. Sadly, Andrew's leukemia was too aggressive and he lost his battle on December 15th, 2019. Since its creation, ALG has dedicated the majority of its efforts towards providing products that we know Andrew would have enjoyed and that help make the difficult job of a Child Life Specialist just a bit easier. We are excited to now be able to expand our ability to support those who will help so many through their toughest days.
Name*

First NameLast Name
Date of Birth*

MonthDayYear
Mobile Phone Number
E-mail*
Mailing Address*

Street Address

Apt/Unit #

CityState

Zip Code
College / University Name*
Major / Degree*
Current Cumulative GPA*
Anticipated Graduation Date*
College Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Student ID#
Why are Child Life Specialists important? *
Please tell us about your experience supporting medically fragile children and families. Experience may be Child Life volunteer work, Child Life Assistant positions, Pre Internship Experiences/Child Life Practicum or Child Life Internship. *
Why did you choose to become a CCLS?*

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Signature*

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You signature authorizes Andrew's Laughing Gas to contact your college/university to verify enrollment and/or anticipated graduation date.
The application window will close on August 9th, 2024. Upon review of the submitted applications, two CCLS students will be awarded the Andrew’s Laughing Gas scholarship. Recipients will be notified on August 23rd, 2024 of selection and each receive a $1,500 scholarship.
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Andrew's Laughing Gas Scholarship Application Form