(A Unit of Indian Cancer Society)
 

CANKIDS…KIDSCAN SCHOLARSHIP FORM 2009-10

Application for:
Subhash Gambhir Cankids Scholarship for Academic Excellence: junior level (class 1 to 6)
Max New York Life Cankids Scholarship for Academic Excellence: senior level (class 7 and up)
Vimla and K.K. Mehta Cankids Scholarship for Excellence in Sport
Prem Nath Bagai Cankids Scholarship for Creative Arts: Junior level (class 1 to 6)
Kabir Sekhri Cankids Scholarship for Creative Arts: Senior Level (Class 7 and up)
Smt. Arvinda Ben K. Shukla and Shri. K.D.Shukla Cankids scholarship for Music and Singing
Kalavati Shanta Anup Kumar for Creative Writing and Authorship:
Ritsu Spaeth Cankids…Kidscan Social and Community Service Award.
 And Cankids…Kidscan Memorial Award (posthumously)
(If applying for more than one category please mention 1,2,3 in order of your preference)
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A. General Information
Name Of Child Age Date Of Birth Gender
 Clear Date
Name Of Father : Name Of Mother:
Address :  Phone Number: 
Family Financial Status (Monthly Income): Occupation of Father &Mother:
B. Treatment Detail:

Type of cancer: 

Period of Treatment:    Hospital where Treated:

Name of Doctor:

Current Status of the Child:

Hospital Card Number:  

Treatment started From :-  Clear Date

Treatment started To :-  Clear Date
 C. Educational Information:
School /College Name: Class/Year: Subjects Percentage or Marks secured during the last academic year
(please attach report card)		 Period of absence from school/college on account of cancer treatment:

Any other scholarships or prizes won for academic excellence (please attach certificates):
 
D. Excellence in areas outside of Academics:

Participated in:  

Any awards won/ proof of achievement:

Other supporting documents as proof of excellence or description in the chosen area:

Eligibility:

  1. Any Indian who is under 30 years of age and has survived childhood cancer or under 21 years and   battling the disease can apply for the scholarship.
  2. Applicants who had applied last year are also eligible.

Instructions:

  1. Please fill the form and send it with the relevant documents and also mention “Scholarship Program 2009” at the top of the envelop and send it to the following address: D 7/7, Basement, Vasant Vihar, New Delhi - 110057
  2. If applying for more then one category, applicant must list them in the order of priority in which he/she seeks the award.
  3. Our panel of eminent judges will decide the winner.
  4. Fresh applicants would be given more preference over previous year winners
  5. Last date of the submission of the form is 15th June 2009.
  6. The Awards will be announced on the eve of 15th of August.
  7. Winners will be informed in advance and they must be present at the award ceremony else the award will go to the next in line.Tavelling allowances will be provided to them.
  8. For further contact and queries please contact: Abhijit Roy call: +91-9971841305 or email: abhijit@cankidsindia.org 

Attachments Required: 

  1. 2 photographs of the child (one passport and one any nice attractive photo);
  2. Report Card of last academic year
  3. All supporting documents and proof of “excellence”
  4. Essay by child
  5. Recommendation Letter

Disclaimer. All the material submitted to Cankids for the purpose becomes the intellectual property of Cankids to be used or displayed as and when deemed necessary.

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