Individual Application for Scholarship

Please read the information and fill out electronic form below

If you prefer to fill out the form and fax or mail back, please download the pdf below.

Please fill out and fax back.  fax: 630.378.5370

Any supplemental documentation not in electronic format may
be sent via fax above or mailed to address below.


Give Me A Chance Foundation 612 Territorial Drive, Suite B Bolingbrook, IL 60440