2026 Scholarship Application

2026 Scholarship Application
Section A: Personal Information
Name*

First NameLast Name
Date of Birth*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Email*
example@example.com
Section B: Education/Path
What type of student are you?*
A traditional student is defined as a graduating high school senior planning to attend secondary education at an accredited college/university/technical school. A nontraditional student is defined as any other individual planning to attend an accredited college/university/technical school.
Work experience (if applicable)
Describe any work experience you have had.
Extracurricular Activities
List any clubs, sports or activities that you participated in through your highschool career.
Awards and Honors
List any awards, honors, or special accolades you have received.
Community Involvement
Describe any civic, religious, community or volunteer activities you have been involved in.
What highschool did you graduate from?*
What highschool will you be graduating from?*
What is the name of College, University, or Technical School you plan to attend?*
What major/area of study do you plan to pursue?*
Expected Date of Graduation*
Month-Year
YesNo
GPA (Grade Point Average)
Submit Official Transcript

Please submit a .PDF document of your official high school transcript. This should be available from the school in which you graduated.
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A transcript is preferred. If you cannot provide a transcript or GPA to the scholarship committee please explain why.
Section C: References
Letters of Professional Reference Upload*

Please upload two letters of professional reference to accompany your application. (e.g. employer, teacher, guidence counselor)
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Section D: Essay
Please submit an essay explaining the following topics:
- Why do you want to pursue an education in your chosen field?
- How has your life been impacted by cancer?
- How will Amanda's light continue to shine through you?
Other topics to consider but not required:
- Describe a personal contribution you have made to your community
- How will receiving this scholarship make a difference to you?
Essay Upload*

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12 Point Font SizeDouble-SpacedNo more than 1,000 words
Scholarship Terms and Signature
Signature*
I certify that the information I have provided in this application is truthful and accurate to the best of my knowledge.
Should be Empty:

2026 Scholarship Application

Section A: Personal Information

Section B: Education/Path

Section C: References

Section D: Essay

Scholarship Terms and Signature