SCUBA Scholarship Application 2021
*Note: Please complete this application to the best of your ability. We are located in Tallahassee, Florida.
Personal Information and Demographics
Name: *
Phone number *
Email address: *
Date of birth: *
Gender *
Street Address: *
City: *
State: *
ZIP Code: *
Highest level of education earned: *
Ethnicity: *
Disability and accommodations needed? *
Employment Information
What is your story? If you are a veteran, what branch of service? How long did you serve and where? Do you have any combat-related injuries or conditions? *
Current employer name and location: *
What are your aspirations for the future? *
If money were no object, what would you do with your time? *
Please copy and paste your resume or CV: *
Describe any leadership roles you have held.
Describe your experience with mentoring and coaching (giving and receiving): *
What are your leadership strengths? *
Activities, Awards, and Community Involvement
What awards have you earned? *
List your favorite activities: *
What community involvement or volunteer activity makes you most proud and why? *
References and Referrals
Please list three (3) references (contact information, how long known, relationship to applicant): *
How did you hear about the Life Worth Leading scholarship? *
If you were referred, please share the name of the person who told you about this opportunity.
I commit to the program in its entirety and agree to actively participate in lectures, pool sessions, and SCUBA diving, and to engage in feedback geared toward developing my leadership skills. *
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