15th Annual Freedom Conference Scholarship Application Form -The Steamboat Institute

Applicant Information

Name*

First MI Last

D.O.B.*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone*

Email*

Social Media Handles (Twitter, Facebook, Instagram, TikTok)*

Background

College (if applicable)

Dates Attended

mm/yyyy - mm/yyyy

Major

Year in School

(Anticipated) Graduation Date

mm/yyyy

Company (if applicable)

Dates Employed

mm/yyyy - mm/yyyy

Position

Are you a citizen of the United States?*

Yes
No

Have you ever been convicted of a felony?*

Yes
No

References

Please list two professional references.

#1 Name*

First Last

Relationship*

Company*

Phone*

Address

Email Address*

#2 Name*

First Last

Relationship*

Company*

Phone*

Email Address*

Background Information

150-word limit per question

1. 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 Involvement

Company/Organization

Job Title/Position

Phone

Responsibilities

Company/Organization

Job Title/Position

Phone

Responsibilities

Company/Organization

Job Title/Position

Phone

Responsibilities

Short Response

250-word limit

In your experience, what do you believe to be the basic roles and responsibilities of government?*

Video Submission

Please 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.

Disclaimer

I certify that my answers are true and complete to the best of my knowledge.*

Yes

15th Annual Freedom Conference Scholarship Application Form