Step 1 of 6 16% Applicant Contact InformationName First Last Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Email What is your birth date? MM slash DD slash YYYY Chamber AffiliationPlease select which of the following best describes how you are applying for a scholarship.As the child/grandchild of a Chamber business member.As the child/grandchild of an employee of a Chamber business memberAs an employee of a Chamber business member.What Chamber business are you affiliated with? Please list the name of a person at this business who can verify your affiliation. Education InformationName of High School you are graduating from Number of students in your family (not including yourself) enrolled in post-secondary education as of Fall 2022: Do you have any special circumstance regarding your financial situation? If so, please explain: College/University/Trade School InformationSchool Name School Address What are your total estimated annual costs to attend this college/institution? (Please include tuition, room and board, books and other related expenses) Extracurricular ActivitiesACTIVITIES: Please list all the activities you have participated in and any titles associated with each activity. Also include when you began and ended (if it applies) the activity. (e.g. Varsity Baseball Team, Captain, Sept. 2020 - June 2021, Chess Club, 2020-2022)AWARDS: Please list any awards you have received. Include the name of the award, the organization that gave you the award and the date you received it. (e.g. Honor Roll, Stoneham HS, Sept. 2021)EMPLOYMENT/INTERNSHIPS: Please list any jobs you have held (or currently hold) including the names of the companies, any title(s) associated with your employment and when your positions began and ended. (e.g. Stoneham Chamber of Commerce, Assistant, Sept. 2019-January 2022) Personal EssayYour personal essay should be approximately 500 words and address the following question: The mission of the Stoneham Chamber of Commerce is to promote local business, develop a positive economic environment and contribute to the betterment of the community. Our Chamber members recognize their obligation to give back to the communities in which they live and work. Kathleen E. Bray enriched Stoneham through promotion of the arts and culture. John F. Mahoney improved Stoneham through community service. Looking toward the future, how do you see yourself enhancing the community you live in?FileMax. file size: 16 MB. Share this:Tweet