Bursary Application Form

Personal Information

Full Legal Name Birth Date Phone Number Email Address Street Address City Province Postal Code Parent / Guardian Name Relationship to Youth (Mother, Father, Other: Please Specify) Parent / Guardian Phone Number Are you a Canadian citizen? YesNo

Post-Secondary Information

Are you a first generation college student? Yes, I am first among my parents or grandparents to attend college.No, either my parents or grandparents have attended college. Post-Secondary School Information (College/University where you have applied or been accepted) Intended Field of Study Have you applied for any other scholarships? YesNo

High School Information

Name of high school attended Date expected to graduate If you have a GED Certificate for High School Equivalency, please provide the date you received it. Academic awards and/or honors you received in High School Are you a member of any clubs in your school? If yes, please detail which clubs and your role. Are you a member of any organization outside your school? If yes, please detail which organizations and your role. Do you volunteer within the community? If yes, please state where and in what capacity.

References

Reference 1 Name Reference 1 Phone Number Reference 1 Email Reference 2 Name Reference 2 Phone Number Reference 2 Email

Bio

Your bio should be 300-500 words. Please detail the ways that you have served the people within your community. You should address in your bio your university goals and choice of major, what you intend to do with your education, and why a bursary is important to you. Include any academic and non-academic accomplishments, personal characteristics, or experiences that make you uniquely worthy of bursary consideration.