SCHOLARSHIP APPLICATION FORM

To complete this application, you are required to submit the following:

• A current transcript from your high school (or CEGEP) confirming an 85% or greater average
• Three letters of reference from individuals who know you well and are able to describe your character, personal qualities, and academic and non-academic accomplishments
• A personal essay that, as a general guideline, addresses interests and non-academic qualities, describes your future education and career goals, and outlines how you hope this scholarship will help you achieve your goals. Specifications: maximum 350 words, double-spaced, 12 pt Arial font, and word count at the end of your essay

It is important to mention that we are expecting examples that demonstrate your skills for leadership, collaboration, communication, your ability to interest people in issues that you are passionate about, and that your lifestyle is characterized by honesty, integrity, respect and compassion.

General Information

First Name: Last Name:
Select your gender: Male Female
Are you Aboriginal/Indigenous? Yes No
Address:
Phone:
Email:
Name of parent(s), next-of-kin or guardian:
Address (if different from above):
Phone:

Education

Institution currently attending:
Name and location of institution you plan to attend next fall:
Program:

Awards and/or Recognition

Please list any awards or recognitions you have received (maximum 250 characters):

(Maximum characters: 250)
You have characters left.

Work and/or Volunteer Experience

Organization 1

Name: Position Held:
Address:
Dates:

Organization 2

Name: Position Held:
Address:
Dates:

Organization 3

Name: Position Held:
Address:
Dates:

References

Reference 1

Name:
Phone:
Email:
Relationship to you:
How long has this person known you?:
Attach Letter Here:

Reference 2

Name:
Phone:
Email:
Relationship to you:
How long has this person known you?:
Attach Letter Here:

Reference 3

Name:
Phone:
Email:
Relationship to you:
How long has this person known you?:
Attach Letter Here:

Additional Requirements

Attach current transcript here:
Attach personal essay here:

I hereby agree that the information provided is correct and can be certified upon request.


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