Memorial Scholarship Application 2020

Applicant Name *

Address

City

State/Province

ZIP Code

Country

United States Canada 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 Bosnia and Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory Brunei Darussalam Bulgaria Burkina Faso Burundi Cambodia Cameroon Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos Islands Colombia Comoros Congo Congo Democratic Republic of Cook Islands Costa Rica Coted Ivoire Croatia Cuba Curacao Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands 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 Mc Donald Islands Holy See Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Isleof Man Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati Korea Democratic Peoples Republic Korea Republic of Kuwait Kyrgyzstan Lao Peoples Democratic Republic 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 Northern Mariana Islands Norway Oman Pakistan Palau Palestine Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Reunion Romania Russian Federation Rwanda Saint Barthelemy Saint Helena Saint Kitts and Nevis Saint Lucia Saint Martin 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 Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia and the South Sandwich Islands South Sudan Spain Sri Lanka Sudan Suriname Svalbard and Jan Mayen Swaziland Sweden Switzerland Syrian Arab Republic 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 Minor Outlying Islands Uruguay Uzbekistan Vanuatu Venezuela Viet Nam Virgin Islands British Virgin Islands US Wallis and Futuna Western Sahara Yemen Zambia Zimbabwe Sark

Telephone

Email

NIBA Member Company

Employee Name

Relationship to Employee

Employee's Email

Employee's Phone

Will you have completed high school or obtained your GED by summer 2020?

Yes

No

Do you plan to attend a 2- or 4-year accredited college, university, or technical school?

Yes

No

School Name

Service Activity #1 - Organization

Dates of Service #1

Activities Performed #1

Leadership Roles #1

Brief Description of Leadership Roles #1

If applicable

Number of People Led #1

Estimated Annual Hours Volunteered #1

Service Activity #2 - Organization

Dates of Service #2

Activities Performed #2

Leadership Roles #2

Brief Description of Leadership Roles #2

if applicable

Number of People Led #2

Estimated Annual Hours Volunteered #2

Service Activity #3 - Organization

Dates of Service #3

Activities Performed #3

Leadership Roles #3

Brief Description of Leadership Roles #3

if applicable

Number of People Led #3

Estimated Annual Hours Volunteered #3

Service Activity #4 - Organization

Dates of Service #4

Activities Performed #4

Leadership Roles #4

Brief Description of Leadership Roles #4

if applicable

Number of People Led #4

Estimated Annual Hours Volunteered #4

Service Activity #5 - Organization

Dates of Service #5

Activities Performed #5

Leadership Roles #5

Brief Description of Leadership Roles #5

if applicable

Number of People Led #5

Estimated Annual Hours Volunteered #5

Service Activity #6 - Organization

Dates of Service #6

Activities Performed #6

Leadership Roles #6

Brief Description of Leadership Roles #6

if applicable

Number of People Led #6

Estimated Annual Hours Volunteered #6

Additional Comments

Essay Topic

1. How will this scholarship impact your future?

2. Explain the importance of (your major) in today’s society.

3. Pick a controversial problem on college campuses and suggest a solution.

Upload Your Essay *

20MB max

GPA *