2019 College Scholars Application

You can submit this form electronically by clicking "submit" at the end of this form, or print and mail it to our office at:

Children’s Cause for Cancer Advocacy   |   1325 G Street NW, Suite 540   |   Washington, DC 20005

Please send the rest of your application materials by mail to the above address OR electronically to info@childrenscause.org

Application deadline is March 31, 2019

Name *
Address *
Phone *
To complete your application, submit each of the following materials:
I give my permission to CCCA to use my first name and story on CCCA’s website and other electronic communications from CCCA. I also give CCCA permission to use my name, location, and school attending in the fall if awarded a scholarship. *