Children of Hope Scholarship Application

APPLICANT INFORMATION

Name(Required)

First Last

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone(Required)

Email(Required)

LPHOH Retreat Information

Year of Little Pink Retreat(Required)

Little Pink Retreat Location(Required)

Name of Parent Recipient of LPHOH Retreat(Required)

Parent/Guardian Information

Parent/Guardian Name(Required)

First Last

Parent/Guardian Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Parent/Guardian Phone(Required)

Parent/Guardian Email(Required)

Applicant Education Information

HIGH SCHOOL SENIORS ONLY

Current High School Attending(Required)

Current GPA(Required)

GPA - Weighted or Unweighted(Required)

Intended Major

Name of the College(s)/Trade School(s)/University(s) Applicant is Planning to Attend(Required)

I plan on enrolling(Required)

Additonal Applicant Information

Applicant Essay: Please touch one or more of the following topics: - The effect of attending a LPHOH retreat and/or your parent's breast cancer diagnosis on you. - What are your college, career and life goals? - What is motivating you to attend college/trade school? Required word count between 800-1000 characters.(Required)

Applicant Service Essay: Little Pink is rooted in the core value of serving others. This year, an additional Doris Harrington Servant Leadership Scholarship will be awarded to one applicant with service as a high priority of focus in the deliberation. Please explain how you have incorporated service into your life, what it means to you, and how you plan on growing this area of your life in the future.(Required)

Student & Parent/Guardian Release

Student & Parent/Guardian Release - By applying for this scholarship, students agree to give Little Pink Houses of Hope permission to use the applicant's name, photographs of self and family, and application information on all promotional material, social media pages, and the official foundation website, www.littlepink.org. Both the student and parent/guardian must read the following statement and sign as indicated. - "We affirm that the information provided on this application is accurate to the best of our knowledge. We understand misrepresentations may constitute fraud, which may result in loss of eligibility of this scholarship or have other legal consequences. We give permission for the Selection Committee of Little Pink Houses of Hope Children of Hope Scholarship Fund to review the information provided.

Applicant Signature(Required)

Date(Required)

Parent/Guardian Signature(Required)

Date(Required)