Tecan Scholarship Program

First and Last Name*

Tecan Employee Sponsor Name*

What grade are you in?*

What is the name of your School?*

How old are you?*

What is your email address?*

Parent's email if under 13 years of age

Address*

Street, City, State, Zip

Country*

Select

Qualified Program Details*

Please include dates of the program, cost/tuition, Registration, etc. If you are able to upload a flyer at the next question, that will suffice or a link to the program's website.

Please upload the following:*

Photo of yourself
A flyer of your program, if applicable
Your video or essay submission

Drag and drop files here or