MERCHANTS EXCHANGE SCHOLARSHIP APPLICATION 2024 APPLICANT INFORMATIONName* First Middle Last Applicant email – primary* Applicant email – secondary Phone*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 FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Secondary Contact Name* Only will be contacted in the event of unable to contact applicantSecondary Contact Phone Number*How did you learn about the Merchants Exchange Scholarship?Merchants Exchange – EmailMerchants Exchange – WebsiteProfessorSupervisorSchool's Website/Scholarship PortalAmerican Maritime PartnershipThe Professional MarinerCappexFastwebScholarship OwlScholarshipExpertsScholarships.comWashboardZinchOther – please indicate belowOther: CURRENTLY ATTENDING/ENROLLED IN:Current College, University or US Coast Guard (USCG) Academy or program* Matriculation Date* MM slash DD slash YYYY Type of Institution or Program*2-year college4-year college, not affiliated with the US Coast GuardUS Coast Guard Academy or approved programGraduate SchoolMajor/Field(s) of Study* Current Academic Standing*First Year in a Two Year ProgramSecond Year in a Two Year ProgramJunior in a Four Year ProgramSenior in a Four Year ProgramGraduate Student (any year)Short course (less than 2 years) in a US Coast Guard-Approved programStudent ID Number* Current GPA/Equivalent Ranking* Accumulated Credits* Enrolled Credits* Expected Graduation Date* MM slash DD slash YYYY Previous Recognized Educational Institution AttendedPreviously Attended Educational Institution Name Year(s) attended previous institution Degree/Credit Earned at previous institution Previous GPA APPLICATION QUESTIONSTell us about experiences that influenced your decision to pursue a marine or maritime career and how these experiences will help you in your choice of a specific career.*Personal Statement: Share about your career goals and educational goals.*Please tell us about your paid and nonpaid work history; teams and associations you are involved with, and activities you are involved with. What were your main responsibilities? Highlight leadership roles, special accomplishments and/or recognition received.*PLEASE COMPLETE BOTH PROMPTS BELOW:The lessons we take from obstacles we encounter can be fundamental to later success. Recount a time when you faced a challenge, setback, or failure. How did it affect you, and what did you learn from the experience?*Describe communities you are a member of and what is it about those communities that shaped you?*Please return the following to our office Completed Online Application A Sealed and Certified Official Transcript A letter of recommendation from a professor or supervisor Our Mailing Address: Merchants Exchange Scholarship Fund 200 SW Market St Suite 190 Portland, OR 97201 Or email us at Scholarship@pdxmex.com *please let us know if we should expect a sealed, verified digital copy of your transcript from your registrar* Acknowledgement* I acknowledge that a complete application includes responses to all the questions above, a sealed official transcript and a letter of recommendation from a professor or supervisor postmarked by May 31, 2024, and that I am responsible for sending the required additional documents. CAPTCHA Δ
