2018-2019 Harvey Simon Memorial Scholarship Application
Deadline: January 31st, 2018

Please complete the following scholarship application and mail only your official college transcript (if you will be a college Sophomore, Junior, or Senior in the Fall of 2017) or high school transcript (if you will be a college Freshman in the Fall of 2017) to:

        The Simon Cancer Foundation
        P.O.Box 25093
        Tamarac, FL 33320
*Required Fields
The Simon Cancer Foundation, Inc. is a 501(c)3 tax-exempt corporation designated by the IRS (EIN: 20-3089282) 
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Community Service (Past 4 Years)
Leadership (Past 4 Years)
Essay*

How has your experience with cancer driven you to help others? (1000 word limit)
*Signature
I hereby acknowledge the above is truthful and accurate, and attest to have been diagnosed with cancer during my lifetime.
*Date
Activity
Total Number of Hours
Organization
Leadership Position
Number of Years Held
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