AFA Teen Scholarship Form Step 1 of 2 50% AFA’s 2021 Teens for Alzheimer's Awareness College Scholarship Essay Contest A valid transcript from your high school must be included in the submission or the application will not be considered. Open to all high school seniors who plan to enter an accredited college/university in 2021. Name* First Last Email* Enter Email Confirm Email Address* Street Address City State / Province / Region ZIP / Postal Code United StatesCanadaAghanistanÅland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarrussalamBulgariaBurkina FasoBurundiCambodiaCameroonCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRéunionRomaniaRussiaRwandaSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUruguayUS Minor Outlying IslandsUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabwe Country Phone Number*Are you currently a high school senior?* Yes No AFA's Teens for Alzheimer's Awareness College Scholarship Essay Contest is open to high school seniors who will be attending college next fall. Are you currently a high school senior?*AFA's 2021 Teens for Alzheimer's Awareness College Scholarship Essay Contest is open to current high school seniors. I am a high school seniorI am not a high school seniorAre you planning to attend an accredited college/university in the fall of 2021?*AFA's Teens for Alzheimer's Awareness College Scholarship Essay Contest is open to high school seniors who will be attending college next fall. Yes No Are you planning to attend an accredited college/university in the fall of 2021?*AFA's 2021 Teens for Alzheimer's Awareness College Scholarship Essay Contest is open to high school seniors who will be attending college in the fall of 2021. Yes I amNo I am not Autobiography*Please provide a brief autobiography (200 words or less) in an essay format. Essay*In 1500 words or less, please write an essay answering these following questions: (Please note: Essays less than 1200 words will not be considered) 1. How has Alzheimer's disease changed or impacted your life? 2. What have you learned about yourself, your family, and/or your community in the face of coping with Alzheimer's disease? 3. What are your plans to raise awareness in regards to Alzheimer's disease and dementia? Upload High School Transcript*Accepted file types: doc, docx, pdf.CAPTCHA
AFA Teen Scholarship Form Step 1 of 2 50% AFA’s 2021 Teens for Alzheimer's Awareness College Scholarship Essay Contest A valid transcript from your high school must be included in the submission or the application will not be considered. Open to all high school seniors who plan to enter an accredited college/university in 2021. Name* First Last Email* Enter Email Confirm Email Address* Street Address City State / Province / Region ZIP / Postal Code United StatesCanadaAghanistanÅland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarrussalamBulgariaBurkina FasoBurundiCambodiaCameroonCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRéunionRomaniaRussiaRwandaSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUruguayUS Minor Outlying IslandsUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabwe Country Phone Number*Are you currently a high school senior?* Yes No AFA's Teens for Alzheimer's Awareness College Scholarship Essay Contest is open to high school seniors who will be attending college next fall. Are you currently a high school senior?*AFA's 2021 Teens for Alzheimer's Awareness College Scholarship Essay Contest is open to current high school seniors. I am a high school seniorI am not a high school seniorAre you planning to attend an accredited college/university in the fall of 2021?*AFA's Teens for Alzheimer's Awareness College Scholarship Essay Contest is open to high school seniors who will be attending college next fall. Yes No Are you planning to attend an accredited college/university in the fall of 2021?*AFA's 2021 Teens for Alzheimer's Awareness College Scholarship Essay Contest is open to high school seniors who will be attending college in the fall of 2021. Yes I amNo I am not Autobiography*Please provide a brief autobiography (200 words or less) in an essay format. Essay*In 1500 words or less, please write an essay answering these following questions: (Please note: Essays less than 1200 words will not be considered) 1. How has Alzheimer's disease changed or impacted your life? 2. What have you learned about yourself, your family, and/or your community in the face of coping with Alzheimer's disease? 3. What are your plans to raise awareness in regards to Alzheimer's disease and dementia? Upload High School Transcript*Accepted file types: doc, docx, pdf.CAPTCHA
