Scholarship Winners

Congratulations, Cancer Fighter!

We loved your story and are thrilled that you're helping in the fight to end cancer. To help us process your scholarship award, there are a few more things we need you to do:

Download, review, and complete pages 7-9 of our scholarship's Official Rules ("Affidavit of Eligibility/Release of Liability for Contest Winners").
Tell us how to get in touch with your College/University using our Contact form below.
Upload:
- Your signed and notarized "Affidavit of Eligibility/Release of Liability for Contest Winners"
- A picture of a government issued photo ID (e.g. state ID, driver's license, passport)
- A scanned copy of a signed W-9 form
- High resolution photograph of yourself to be used for publicity purposes.

Contact Information

First name

Last name

Personal Email

College Email

Instagram Handle

Please indicate your IG account handle if you are comfortable being identified in social media posts about your scholarship participation

University/College Name

ID Number (College ID or SS Number)

Name of University/College Office or Individual Receiving Payment

Street Address for University Office Receiving Payment

Street Address Line 2

City

State

Zip Code

How did you hear about SMAC's Cancer Fighter Scholarship?

Family/friends

SMAC chapter communication

SMAC website

SMAC email

Guidance counselor

Internet search

Scholarship database

Other

If "other," please specify:

Your signature

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Signature of Legal Guardian if a minor

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Affidavit of Eligibility/Release of Liability for Contest Winners (pages 7-9 of our Official Rules)

Upload .pdf or .jpeg file (Max 15MB)

Copy of Photo ID

Upload .jpeg file (Max 15MB)

Signed W-9

Upload a scanned copy of your W-9 as a .pdf

High Resolution Photograph

Upload .jpeg or .png file (Max 15MB)

I certify that I have reviewed the Official Rules.

Scholarship Winners

Congratulations, Cancer Fighter!

Contact Information

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