Ancient Egyptian Arabic Order, Nobles of the Mystic Shrine of North and South America and its Jurisdictions, Inc. (A.E.A.O.N.M.S.)
Noble John C. McDougal
Memorial Scholarship ProgramApplication - due May 1, 2026
Applicant Information
Name
First Name
Last Name
Suffix
DOB
-
Month
-
Day
Year
Date
Email
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Mobile Number
-
Area Code
Phone Number
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As the parent/guardian of the applicant, I hereby grant MISR Temple No. 213 the unrestricted right and permission to use and re-use my child’s name and likeness in any and all publications, including photograph, television broadcast, video recording, internet sites, audio-recording or any other form of electronic or print communication (the promotional materials), for its own purposes without payment or any other consideration to me or my child, in perpetuity. I understand and agree that any material produced using my child’s likeness is the property of MISR Temple No. 213. *Please note, if a photo release is not provided, the recipient cannot be photographed in group pictures. The pictures can be published.
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Parent Name and Date
High School Information
Name of School
School Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Counselor Name
First Name
Last Name
Expected Graduation Date
-
Month
-
Day
Year
Date
Cumulative GPA
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Recommendation Letter
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Parent/Legal Guardian Information
Parent Name
First Name
Last Name
Parent Mobile Number
-
Area Code
Phone Number
Parent Email
example@example.com
Is any member of your family a member of Misr Temple #213 or Misr Court #193?
Please Select
Yes
No
If yes, what is their name?
College Intent
Intended Major(s)
First Choice College
Admitted?
Please Select
Yes
No
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Second Choice College
Admitted?
Please Select
Yes
No
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Upload Brag Sheet/Resume
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Include academic and other awards, extracurricular activities, and community service activities since grade 9.
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Applicant (Print Name)
Parent/Guardian (Print Name)
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