College Scholarship Application Form

Name*

First Last

Address*

Street Address Address Line 2 City State ZIP Code

Email*

Phone*

Best way to reach you:*

Please list the accredited college, university, trade school, technical school, or vocational school that you will be attending in 2025-2026.*

What year were you diagnosed with an eosinophil-associated disorder?*

What eosinophil-associated disease do you have? (Please select all that apply.)*

Please upload a letter from a physician or healthcare provider documenting your diagnosis.*

Accepted file types: pdf, jpg, png, Max. file size: 25 MB.

The letter must include your name, your diagnosis, and your doctors name and contact information.

Please upload your academic transcript from the most recent school year.*

Accepted file types: pdf, jpg, png, Max. file size: 25 MB.

The transcript must include the name of your school and your cumulative GPA.

Please upload one document with two essays: (A) How has an eosinophil-associated disease made a difference in my life? (900 words or less); (B) How have you participated in APFED’s mission to educate, advocate, raise awareness, or support research for eosinophil-associated disease and/or engaged with APFED’s events (e.g., attended conference, participated in a fundraiser, etc) ? (750 words or less) Label each essay and include your name on your uploaded document.*

Accepted file types: pdf, Max. file size: 25 MB.

APFED's Contact List

Yes, I consent to APFED contacting me with information about current events, news of interest, and opportunities to support the eosinophilic community.

Acknowledgement*

I certify that the information provided in this application, is to the best of my knowledge, both accurate and complete. In the event that I am selected to receive a scholarship: I authorize APFED to announce and publicize my scholarship in any manner it considers reasonable including my name, school I will be attending, and portions of my essay responses. I understand that I will be required to provide documentation of enrollment and other information prior to the release of scholarship funds to my school.

I agree
I do not agree

Legal*

I hereby acknowledge that I have read and agree to APFED's Terms of Use and Privacy Policy.

Comments

This field is for validation purposes and should be left unchanged.

College Scholarship Application Form

APFED/EleCare® College Scholarship Application