Scholarship | ACSGWC

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First name*

Last name*

Email*

Phone*

I acknowledge that the applicant has Autism and/or a related disorder.

High School*

Reference*

How do you plan to use the $500 scholarship?*

Why do you believe you deserve this scholarship?*

410-352-5011

P.O. Box 1322

Ocean Pines, MD 21811

Name*

Email*

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