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Kingston and Luka Memorial Scholarship
The Kingston and Luca honorary scholarships created by our foundation to honor Kingston and Luca and their amazing Moms who climbed Kilimanjaro and raised $17,000 CD for our PTEN community. We hope these $500 USD scholarships will provide joy and hope to our Canadian PTEN families.
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Have you been diagnosed with a PTEN mutation? *
If chosen for a scholarship award would you be willing to provide documentation of your PTEN mutation? *
Please let us know why this scholarship award will help your family. Your response will remain confidential. *
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This form was created inside of PTEN Hamartoma Tumor Syndrome Foundation.

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