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Application Open!

Welcome to this years application round! Be sure all of your information is correct before you submit. We can't wait to hear from you!

Days left to Apply

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First Name

Last Name

Email Address

Phone

Street Address

City

State/Zip

Completed High School With:

Higher Education:

School Planning to Attend

School Address

Contact Name and Information:

Expected Start Date?

Anticipated Graduation Date?

Planned Major? Planned Major? Yes No

Major?

Achievements (if applicable)

Community Involvement (if applicable)

Mental Impact Essay (600 words or less): Please provide an essay detailing your own personal history or struggles with mental illness or a personal experience with a loved one who suffers from mental illness. Please describe the impact this has made in your life.

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