Dauminique Bouvier Smalling Counseling Scholarship

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Dauminique Bouvier Smalling was a resident in the East Ramapo community who lost her battle with sickle cell disease at the young age of 20 years old. As she struggled with surviving, Dauminique and her family were unaware of counseling services that were provided by Falling Angels Sickle Cell Foundation. After learning about Dauminique’s early demise, the foundation decided to dedicate their counseling program after Dauminique Bouvier Smalling. It is a legacy to her memory. The foundation also hired two certified counselors, specializing in providing support to those affected with sickle cell and their family. These counseling sessions will provide a voice for those affected by this debilitating disease. The service is free for a limited number of sessions. The foundation also provides financial assistance towards medical bills for those experiencing hardships. We provide grants up to $1,000 for various services. We continue to be advocates for those with sickle cell disease.

Dauminique Bouvier Smalling Counseling Service Application

FALLING ANGELS SICKLE CELL FOUNDATION
SCHOLARSHIP PROGRAM APPLICATION FORM

This application form and all other required documentation must be emailed to fallingangelsscf@gmail.com
or contact us through our website: www.fallingangelsscf.org. To qualify for this scholarship, a 1,000 word essay must be submitted with this form.

Students must check this criteria to be eligible.

I confirm that I am attending college at the present time.

I live in the United States (Rockland County).

I will be attending a college in the United States.

Have you received a scholarship from this foundation before?

Yes

How did you hear about the Falling Angels Sickle Cell Foundation?

Social Media

Friend

Hospital

Other

First Name

Middle

Last Name

2. Home Address

Address

City

State

Zip Code

Phone Number

Secondary Phone

Ext.

E-Mail

Date of Birth

What school (High School/College) did you attend?

Address

City

State

Zip Code

Phone Number

Current GPA

Required for High School students only - College admission composite test score(s). Attach photocopies of all score reports.

ACT

SAT

Other

What college will you be attending?

City

State

Zip Code

Undecided. Colleges under consideration:

Classification in fall semester:

What degree(s) are you pursuing?

What profession or field of employment do you wish to enter with your college degree?

Anticipated year of college graduation:

List any postsecondary institutions you have attended:

Name

City

State

Zip Code

Name

City

State

Zip Code

Essay

What does the scholarship committee need to know about you in 1,000 words or less is required? The committee members will be especially interested in these points: your most notable qualities, your attitude about Sickle Cell Disease.

Attach your essay to this form. The essay is limited to no more than 1,000 words, two printed pages (approximately 6,000 characters). Carefully proof read your essay.

Essay

Certification Statement:

Sign

Date

Dauminique Bouvier Smalling Counseling Service Application

Essay

Certification Statement:

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