The application process involves filling out the application form and sending it to us with the following information:

  • The completed application form. First time applicants MUST submit a medical statement from one’s doctor describing their cancer diagnosis. Past recipients are encouraged to submit a current medical statement.
  • Latest school transcript from high school or college.
  • Current letter of recommendation from an employer or school authority (other than a relative).
  • Signed publicity release.
  • Recent photograph.

Our Scholarship Application Form gives you several options for completion and submission.

Options for completing the application form.

  1. Enter the information directly online. After completing the form, Save it to your desktop and email it to us at: Print it for your records.
  2. Save the application form to your desktop. Enter the data by typing it onto the form. Save it and email it to: Print it for your records.
  3. Save the application form to your desktop and enter the data manually by pen. Please use black or blue ink to complete the form. Save it and print it for your records. You may scan the form and email it to us Or, you may mail the completed application to:
    Ms. Kelly Frey Pollard 117 Imperial Ave Westport CT 06880

Note: Use a separate sheet of paper if additional information is required.

All of the information will be kept in the strictest confidence.

To be eligible for consideration, applications must be submitted by April 1st for the upcoming academic year. Each applicant that meets the requirements will be interviewed by the Board of Directors. You will be contacted as to the date and time for an appointment.

Our annual scholarship reception for recipients and their families/friends will be held on June 26, 2016. Invitations to the event will be send out in mid-June after individual awards have been determined.

* If unable to print application – Scholarship applications are available through high school guidance offices or by contacting:

The Susan Fund, Inc.
8 Hilly Field Lane
Westport, CT 06880
(203) 226-4145
For additional information, please contact Mrs. Lloyd at the above address or telephone number.

Scholarships Form