Survivor Scholarship

The Childhood Cancer Canada Survivor Scholarship is a one-time $1,500 award for full-time students in any university, college, or vocational training program. Students may be in any year of their studies provided that they are enrolled in school for the fall term in which the scholarships are awarded.

The TEVA Canada Survivor Scholarship is a one-time $5,000 award granted to a maximum of ten full-time students entering (or already enrolled in) pharmacy, medicine, or health sciences post-graduate program of study. Students may be in any year of their studies provided that they are enrolled in school for the fall term in which the scholarships are awarded.

Application Checklist

  • Application form, fully completed and signed
  • Note: In order to receive your scholarship cheque, you must provide your Social Insurance Number (SIN) as a T4 will be issued for tax purposes
  • Statement from your oncologist or current family doctor confirming that you were treated, or are currently being treated, for childhood cancer (age 0-18).
  • 400-500 word personal statement
  • Current digital headshot photo of yourself

Applicant’s Personal Information

I am applying for*:

Name*
First*
Last*
Address*
Street Address*
City*
State/ Province / Region
Postal/ Zip Code
Phone Number*
Home Phone*
Cell Phone*
Email*


Family Information (Parent or Guardian)

Name*
First*
Last*
 
Email*
Phone number*


Health Information

 


Social Insurance Number

In order to receive your scholarship cheque you must provide your SIN #, as a T4 will be issued for tax purposes.
Have you ever received a Childhood Cancer Canada scholarship in the past? *:

Please note, this scholarship program is a one-time award.
Full-time post-secondary institution (university, college, or vocational training program)*:

 


High School Information

City*
Province*
Graduation Year*


University/College/Institution Information

City*
Province*
Expected Graduation Year*


Media Release Form
Authorization to use Written Materials/Photographs
I, hereby authorize Childhood Cancer Canada to use, reproduce, and/or publish all written and/or visual materials, including photographs that may pertain to me. I understand that this material may be used in various publications, public affairs releases, recruitment materials, and/or for other related endeavors. This material may appear on the Foundation's website, as well a full list of the survivor scholarship recipients will be made available on CCC's website. A notification that I have received a Childhood Cancer Canada scholarship may appear in my local newspaper*.

This authorization is continuous and may only be withdrawn by my specific rescinding of this
authorization. Consequently, Childhood Cancer Canada may publish materials, use my name,
photograph, and/or make reference to me in any manner that the Foundation deems appropriate in order to promote/publicize service opportunities.
 
 

WE NEED YOUR HELP!
Do you know that your scholarship is funded by the generosity of donors?  We rely on the kindness of many donors to support the programs we deliver, including the Survivor Scholarship Fund.  Fundraising is vital to program delivery and that’s where you come in.


Importance of Fundraising for Childhood Cancer Canada
Childhood Cancer Canada is focused on saving, enhancing, and extending the lives of children with cancer.

We are the founding funding partner of the C17 Council, an organization composed of institutionally appointed heads of the seventeen pediatric hematology, oncology, and stem cell transplant programs across Canada. Current research being conducted by the C17 includes a focus on the long-term effects of childhood cancer treatments. The hope is that through this research we will be able to determine the factors that influence potential post-treatment physical, social, and cognitive effects as well as the occurrence of secondary cancers.

Our funds also support families through programming. We offer various programs to help navigate the different stages of childhood cancer, such as our emPower Pack Program, Amazing Adventures, Sibling Support, School Resources, Survivor Scholarship, and Benevolent Fund. These programs provide much needed resources not only to the child with cancer, but to the family as a whole.

CCC needs your help to continue funding this life saving research and supportive programming. We ask you to consider giving back by becoming an Event Organizer, at your school or in your community, and help conquer childhood cancer.  Please contact us so that we can help you become a successful
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