Douglas Cowell Memorial Endowed Scholarship Application Scholarship Application – Douglas Cowell Memorial Endowed Personal Information First Name * Last Name * Date of Birth * Email * Home Phone Cell Phone * Address Street Address Street Address Street Address Street Address City City State/Province State/Province Zip/Postal Zip/Postal Country Afghanistan Aland Islands Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bonaire, Sint Eustatius and Saba Bosnia and Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory Brunei Bulgaria Burkina Faso Burundi Côte d'Ivoire Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Cook Islands Costa Rica Croatia Cuba Curacao Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic East Timor Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands (Malvinas) Faroe Islands Fiji Finland France French Guiana French Polynesia French Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Heard Island and McDonald Islands Holy See Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Isle of Man Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati Kosovo Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macao Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia Moldova Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island North Korea Northern Mariana Islands Norway Oman Pakistan Palau Palestine Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Reunion Romania Russia Rwanda Saint Barthelemy Saint Helena, Ascension and Tristan da Cunha Saint Kitts and Nevis Saint Lucia Saint Martin (French part) Saint Pierre and Miquelon Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Sint Maarten (Dutch part) Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia and the South Sandwich Islands South Korea South Sudan Spain Sri Lanka Sudan Suriname Svalbard and Jan Mayen Swaziland Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Timor-Leste Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States United States Minor Outlying Islands Uruguay Uzbekistan Vanuatu Vatican City Venezuela Vietnam Virgin Islands, British Virgin Islands, U.S. Wallis and Futuna Western Sahara Yemen Zambia Zimbabwe Country Background Information Father’s Name Mother’s Name Education Information Current School Cumulative GPA College, University, or Technical College Planning to Attend Education Goals Extra-Curricular School Activities Add Activities? Yes No How Many? (up to 5) One Activity Accomplishments Year (Select all that apply) Freshman Sophomore Junior Senior Two Activity Accomplishments Year (Select all that apply) Freshman Sophomore Junior Senior Three Activity Accomplishments Year (Select all that apply) Freshman Sophomore Junior Senior Four Activity Accomplishments Year (Select all that apply) Freshman Sophomore Junior Senior Five Activity Accomplishments Year (Select all that apply) Freshman Sophomore Junior Senior Community Involvement and Volunteer Experience Add Experiences? Yes No How Many? (up to 5) One Activity / Organization Year (Select all that apply) Freshman Sophomore Junior Senior Two Activity / Organization Year (Select all that apply) Freshman Sophomore Junior Senior Three Activity / Organization Year (Select all that apply) Freshman Sophomore Junior Senior Four Activity / Organization Year (Select all that apply) Freshman Sophomore Junior Senior Five Activity / Organization Year (Select all that apply) Freshman Sophomore Junior Senior Essay Essay (not to exceed 500 words). Describe how you demonstrate any/all of the following characteristics in your life – leadership, strength, compassion, mentoring, community involvement and volunteerism. The applicant should also answer the question, “Why should we choose you for this scholarship?” * E-Signature Printed Name * Date * * By submitting this electronic application, I certify that I reviewed the information and to the best of my knowledge it is accurate. The Committee will use this application to determine scholarship recipients. If you are human, leave this field blank. Submit Δ