Leading with Heart Application Form – A Giving Heart Foundation

Eligibility & Requirements

16 years of age by May 2024
Must have a GPA of 3.0 on a 4.0 scale (or equivalent)
Select a sponsor that can either be a family member that is 21 years of age or older, a teacher or administrator from your school. If your sponsor is not one of these, you would need special permission from A Giving Heart Foundation.

Student Information
How did you hear about the program?
Student Name*
First Last
What name do you prefer to be called?*
Student Email Address*
Enter Email Confirm Email
Date of Birth*
Name of High School*
Current Grade Level*
Current Unweighted GPA*
Name of Parent or Guardian*
Preferred Method of Contact for Parent or Guardian*
Parent or Guardian's Email Address*
Enter Email Confirm Email
Parent or Guardian's Phone Number*
Student's Phone Number*
Student Home Address*
Street Address Address Line 2 City State ZIP Code
Sponsor Home Address*
Street Address Address Line 2 City State ZIP Code
Essay Submission
Please attach a 500 word or less essay on why you would like to be involved in A Giving Heart Foundation Leading with Heart benefiting Ann & Robert H. Lurie Children's Hospital of Chicago.
Upload your Essay*
Accepted file types: pdf, doc, docx, Max. file size: 100 MB.
Accepted formats: *.pdf, *.doc, *.docx
Anything else you would like us to know about you? (Optional)
Letter of Recommendation Submission
Please attach a letter of recommendation from a teacher or administrator from your current High School.
Upload your Letter of Recommendation*
Accepted file types: pdf, doc, docx, Max. file size: 100 MB.
Accepted formats: *.pdf, *.doc, *.docx
Name
This field is for validation purposes and should be left unchanged.