APPLY FOR A SCHOLARSHIP

Scholarship submissions are due by April 1, 2023.

Salutation *

Applicant/Nominee Name *

First

Last

Applicant/Nominee Email *

Confirm Email

Applicant/Nominee Address

Address Line 1

Address Line 2

City

State

Zip Code

Applicant/Nominee Phone *

Parent/Guardian Name *

First

Last

Parent/Guardian Email *

Parent/Guardian Phone *

Current High School Name *

Current School District *

High School Counselor Name *

First

Last

High School Counselor Email *

Confirm Email

High School Counselor Phone *

College/University/School applicant/nominee plans to attend *

Anticipated major in college *

Kindness Initiative or Acts of Kindness Written Description *

Please read the below statements. By checking the box you confirm the statements are correct. *

I understand if I am a recipient of this scholarship the funds will be provided directly to the college/university and are available for the 2024-2025 school year only.
I am a senior in high school graduating in 2024
I ensure the information provided is true and correct. I also understand that any willful dishonesty will result in the refusal of this application.
If I win this scholarship I understand that I will be required to submit a photograph to David’s Legacy Foundation showing me holding the certificate to be used in their promotional materials.

To be completed only when school staff are nominating a student

School Staff Name (Nominator)

First

Last

School Staff Email (Nominator)

Confirm Email

School Staff Phone Number (Nominator)

School Staff Signature and Title (Nominator)