Johnson Cancer Foundation

Scholarship Application Form

Kevin Patoc Scholarship Application

  • Date Format: MM slash DD slash YYYY
  • Contact Details

  • Letters of Recommendation

    Your application requires one letter of recommendation from people who know you well. This letter should be written by someone who can describe your skills, accomplishments and personality. We value these recommendations because they reveal things about you that grades and test scores can't. Please send a request to an individual to provide this information.
  • Drop files here or
    Accepted file types: pdf, doc, docx, jpg.
  • Diagnosis Confirmation

  • Please provide a confirmation of diagnosis letter from a medical professional and must be on letterhead from the hospital or doctor's office and must include their contact information in case we need additional information. This letter can be from an oncologist, a primary care physician, or a nurse from the care team. If you do not have immediate access to this letter, please submit without it and we will ask about it later. Please try to get it if possible.
    Drop files here or
    Accepted file types: pdf, jpg.
  • School Information

  • Note: Please use High School GPA, if college GPA is less than a full year.
  • Income Information

  • College Financial Information

    This section should ideally be completed after you have committed to attend a specific school. This can be either as a continuing student or by submitting your intent to register (SIR) and deposit to the school. Incoming freshman that have not received acceptances and/or submitted their SIR should provide information on their first choice school. Freshman students will be required to update this information when available.
  • (First Choice if undecided)
  • (Published by the school - includes tuition, fees, books, room & board, etc)
  • Expected Family Contribution (EFC) as calculated by FAFSA application (if not filing a FAFSA, use FAFSA4caster accessible here: https://fafsa.ed.gov/FAFSA/app/f4cForm?execution=e1s1)
  • Projected Financial Aid (from FAFSA or FAFSA4caster)

  • Transcripts Request

    Transcripts from at least TWO full calendar years and cumulative GPA on a 4.0 scale. If less than 2 years in college, please provide HS transcripts AS WELL. UNOFFICIAL transcripts ARE acceptable. Two complete years of transcripts are required. College Freshman will need to provide high school transcripts, college sophomores will need to provide high school and college transcripts, college juniors and college seniors will need to provide college transcripts.
  • Drop files here or
    Accepted file types: pdf, jpg.
  • Essays and Personal Statement

    Please answer the following question (300 - 500 words) as part of your completed application.
  • How has cancer affected your life?

  • Tell us about how cancer has affected you individually or personally? (Physically, Emotionally etc.)

    How has cancer affected your family? (Is/Was there a financial, psychological or other impact on your family?)

    How has cancer affected you academically (Did it make academics more challenging? Did it reset your focus to a particular area of study?)

    Tell us how cancer has led you to make a positive impact on the world around you?

    Tell us about your community involvement.

  • Drop files here or
    Accepted file types: pdf, jpg.
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