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Cancer Fighter Scholarship
Application 2026

About Me

First name*

Last name*

Cell Phone*

Email*

Birthday*

Month

Day

Year

Street Address*

Street Address Line 2

City*

State*

Zip Code*

County*

High School Name*

High School Street Address*

High School Street Address Line 2

High School City*

High School State*

High School Zip Code*

Current High School GPA*

How did you hear about our scholarship?*

I'm a SMAC member and heard about it from my chapter

Social media

A scholarship website

Family/friends

School counselor

Other

Please select all that apply

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