This is the official 2017 scholarship application for The University of DeMolay presented by Missouri DeMolay. Please fill it out completely and accurately.

The University of DeMolay will take place July 9th - 14th at the Cedar Creek Conference Center in New Haven, Missouri.

Being a participant at The University of DeMolay is a privilege and an honor. Careful review of applications will be made. Applicants who are selected to be granted a scholarship to attend will receive further instructions and forms to be signed by the Applicant, their Parent(s)/Guardian(s) as well as their Chapter Advisor(s), and for out-of-state applicants, their Executive Officer's signature.

By checking this box, I attest to understanding that while this event does have some indoor 'classroom-style' sessions, the most important experience of the Conference is the Brotherhood gained through leadership and team building activities.
By checking this box, I attest to understanding that this form constitutes an application and does not guarantee admission.

Personal Profile Information

(xxx) xxx-xxxx

DeMolay Career Information

Date:
Date:
0 1 2 3 4 5
Founder's Membership Award
Blue Honor Key
Past Master Councilor's Meritorious Service Award
Representative DeMolay
Chevalier
  Note: preference will be given to young men who have NOT attended in prior years.

Personal Analysis

Health/Medical Information

Sinus Trouble
Fainting
Appendicitis
Cramps in Water
Allergies
Frequent Colds
Hernia (Rupture)
Throat Infections
Diabetes
Convulsions
Ear Trouble
Heart Disease
Epilepsy
Autism
ADD / ADHD
Sleep Apnea

Emergency Contact Information

Insurance Information

Final Submission

By checking this box, I hereby attest that the information provided herein is representative of me and that every field of data has been answered thoroughly and truthfully.
By checking this box, I hereby attest that I have permission granted from my Parent(s)/Guardian(s) and Chapter Advisor(s) [and for out-of-state applicants, my Executive Officer] to submit this scholarship application. Furthermore, I, and they, agree to endorse all necessary forms should I be selected to receive a scholarship to attend The University of DeMolay.