Harold Pittman Scholarship

Supporting Recovery. Restoring Hope.

Scholarship Application

Please complete the application form below. All required information must be provided for your application to be considered.

Full Name

Phone number

Date of birth

Current address

Name and address of the recovery or treatment facility they wish to attend

Type of recovery program or services requested

Length of the program

Total cost of the program

Any additional documentation

Donations are governed by our Donation & No-Refund Policy. External websites and payment providers have their own terms and privacy policies. These terms cover the foundation’s activities. Services offered by Legacy to Legacy Branding LLC are separate.

Harold Pittman Scholarship

Supporting Recovery. Restoring Hope.

Scholarship Application

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