The date field Date of Application is required.
The field How did you hear about the Scholarship? is required.
The field Will you be graduating from High School in 2026? is required.
The field Have you been diagnosed with epilepsy? is required.
The field Who can verify your epilepsy diagnosis? is required.
The phone field Phone # of individual who will verify diagnosis. is required.
The field Briefly describe how epilepsy has impacted your life and your pursuit of your career goals: is required.
The field Email of of individual who will verify diagnosis. must be an email.