Brain Cancer Scholarship

Alexia Surdukan, Andrew Wade Heron, Christian Holley, and Landon Ahrendt

Cancer Survivor Memorial Scholarships
Name

First NameLast Name
Email
example@example.com
Current Mailing Address
City
State
Zip Code
Phone Number
High School SeniorCollege FreshmanGED RecipientOther
Proposed major field(s) of study:
How has being a cancer survivor developed your character? Please give specific examples. If you had to give advice to someone going through cancer, what would you tell them?
What honors, awards and achievements have you earned? What are your education plans, career goals, and personal goals?
The information given in this application is to be used for consideration for an Addi's Faith Foundation Memorial Scholarship. I pledge that all information provided is correct to the best of my knowledge. I also understand and agree that the decision made by the Addi's Faith Foundation on my application will be final.
Signature of Applicant

Clear
Date

MonthDayYear
Date
Scholarships will be mailed directly to institutions, so please ensure that the following information is included correct.
School Name (check payable to):
School Check Mailing Address:
"Partial" Transcript - High School Seniors

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Full Transcript - College Students

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Confirmation of Treatment for Brain Cancer

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Refernce #1
Full Name
Phone Number
Email Address
Reference Letter

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Reference #2
Full Name
Phone Number
Email Address
Reference Letter

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Your Photo (This is not required, but we would love to put a face with a name!)

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Final selections are based on: Application essays, reference letters, academic grade point average, personal interview, and scholarship donor criteria

References: Two references can be anyone not related to you or living in your household. One evaluation should be submitted by teachers, administrators, or counselors connected with the school in which you are currently enrolled or have been enrolled. For students who have not been enrolled in school for a period of more than two years, references should be from an employer, minister, supervisor, etc. Do not submit references from relatives and neighbors. A second reference should be from a doctor or hospital that directed your cancer treatment.
Should be Empty:

Scholarships will be mailed directly to institutions, so please ensure that the following information is included correct.

Refernce #1

Reference #2