Delegate Application - Bainbridge Ometepe Sister Islands Association

Student Information

Name (first and last)*

Preferred Pronouns

Date of Birth*

Cell Phone*

Email Address*

Home Address*

Street Address Address Line 2 City State ZIP Code

Your Current High School*

Bainbridge High School

Eagle Harbor

Hyla High

West Sound Academy

Other

Grade in School*

Current or most recent Spanish class:*

Parent/Guardian Information

Parent or Guardian Name*

Parent or Guardian Address*

Street Address Address Line 2 City State ZIP Code

Parent/Guardian Cell Phone*

Parent/Guardian Email*

Add another Parent/Guardian?*

Yes

Second Parent/Guardian Name

Second Parent/Guardian Address

Street Address Address Line 2 City State ZIP Code

Second Parent/Guardian Cell Phone

Second Parent/Guardian Email

Application Questions

1. Describe your involvement in any of the following: community and school events, teams, special service projects, hobbies, clubs, work and travel. Briefly relate how these experiences would benefit you as a student delegate.*

2. The stated purpose of the Bainbridge Ometepe Sister Islands Association is to promote friendship and mutual understanding between the residents of Bainbridge Island and Ometepe. How can you as a student delegate contribute to this mission?*

3. During your stay on Ometepe, you will experience many cultural and environmental differences that may be challenging. Describe a challenging experience you have had in the past and how you dealt with the situation.*

4. En un párrafo, explique brevemente unos aspectos de la vida en Ometepe que le gustaría conocer más y por qué (en Español).*

5. How did you hear about BOSIA and the student delegation trip?*

Signature

All Ometepe delegation ACTIVITIES and individual TOWN MEETINGS are important building blocks for your success as a member of the Student Delegation. You are expected to attend all scheduled activities and meetings.*

By typing my name below I indicate that I understand the statement above and will commit to attend all scheduled meetings and activities.

Fees

Initial deposit of $250 should be paid by check to “BOSIA” and mailed to BOSIA Student Delegation, PO Box 4484, Rolling Bay, WA 98061.

Candidates not selected will have their deposit refunded.

Final payment is due in March 2024. Approximate cost is $2500, which includes all expenses, including airfare.

To apply for a scholarship contact Betsy Carroll at pbcarroll@gmail.com.

This field is for validation purposes and should be left unchanged.

BOSIA Student Delegation Application

Student Information

Parent/Guardian Information

Application Questions

Signature

Fees

Title