Before uploading your application, please ensure you have the following items:

1. A photo release form signed by the nominees’ parent or legal guardian
2. At least 1 but no more than 3 headshots of the nominee (1 MB in total)
3. Shirt size of nominee (will be used if student is selected as a fund recipient)
4. Brief essay (no more than 500 words)
5. Student’s mailing address

Mentor's Name(Required)

First Last

Mentor's Email(Required)

Mentor's Phone Number(Required)

Student's Name(Required)

First Last

Name of student being nominated

Student's Grade(Required)

Please only input a number

Student's Age(Required)

Gender(Required)

Male

Female

*Student's Shirt Size(Required)

Please ensure the size is accurate as we will be using this to purchase sweatshirts for grant recipients. The sizes reflected here are for adults.

Other Shirt Size

Student's School Name(Required)

Student's Team Name and Team Number(Required)

* Student's Home Mailing Address(Required)

* To be used if student receives funding

Street Address Address Line 2 City Province Postal Code

HTML Hyperlinks

Photo Consent Form

Please have a parent or legal guardian fill out and sign the Photo Release Form. Once signed please upload with your application.

Essay (Max 500 Words)(Required)

Max. file size: 512 MB.

Paren/Legal Guardian Photo Release Form(Required)

Max. file size: 512 MB.

Student's Pictures(Required)

Please include up to (3) three headshots

Drop files here or

Max. file size: 14 MB.

Signature(Required)