To apply for the Dr. Lawrence Reimer Memorial Bursary please fill out the form below.
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.
Input this code:
