14th Annual Freedom Conference Scholarship Application Applicant InformationName* First MI Last D.O.B.* Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwe Phone*Email* Social Media Handles (Twitter, Facebook, Instagram, TikTok)*BackgroundCollege (if applicable)Dates Attendedmm/yyyy - mm/yyyyMajorYear in School(Anticipated) Graduation Datemm/yyyyCompany (if applicable)Dates Employedmm/yyyy - mm/yyyyPositionAre you a citizen of the United States?*YesNoHave you ever been convicted of a felony?*YesNoReferencesPlease list two professional references.#1 Name* First Last Relationship*Company*Phone*AddressEmail Address*#2 Name* First Last Relationship*Company*Phone*Email Address*Background Information150-word limit per question1. How did you hear about this opportunity?*2. Why do you want to attend Steamboat Institute’s Freedom Conference?*3. What do you look forward to gaining from attending the Freedom Conference?*4. How will you bring back what you learn at the Freedom Conference to add value to your communities?*Previous InvolvementCompany/OrganizationJob Title/PositionPhoneResponsibilitiesCompany/OrganizationJob Title/PositionPhoneResponsibilitiesCompany/OrganizationJob Title/PositionPhoneResponsibilitiesShort Response250-word limitIn your experience, what do you believe to be the basic roles and responsibilities of government?*Video SubmissionPlease explain to the scholarship committee how you learned about the Steamboat Institute and the Freedom Conference Scholarship. Additionally, please describe a cause that you are passionate about and articulate why attending the Freedom Conference will empower you to take action. This does not need to be a high-quality production; cell phone videos are fine.Video Link (videos should be 3-5 minutes in length)*Embed video link via Youtube, Vimeo, or Dropbox. If you are unable to create a link, please email the video to [email protected] with Freedom Conference Scholarship Application Video in subject line.DisclaimerI certify that my answers are true and complete to the best of my knowledge.* Yes Share this