2017 Gary Wagar Scholarship

NCSO Application Form

Description

The University of Alberta (U of A) and the Alberta Construction Safety Association (ACSA) have established a scholarship in honour of former ACSA Executive Director Gary Wagar. The goal of this partnership is to encourage and support students who wish to further their careers in the healthand safety profession.

This annual $1000 scholarship will be presented to an individual whohas attained the National Construction Safety Officer (NCSO) designation through the ACSA, and willallow the recipient to continue his or her professional development in the Occupational Health & Safety Certificate program at the U of A. The winner will also receive a complimentary registration to the NCSO Professional Development Conference, being held in Edmonton on March 9 &10, 2017.

Eligibility

This category is open to individuals who:

  • Have an NCSO designation, certified through the ACSA
  • Have a proven desire to pursue further education in health and safety
  • May already be a student in the UofA’s OHS Certificate Program

Conditions

Note the following important conditions of application:

  • Self-nominations are permitted
  • Each question must be addressed in the application form
  • Applicants are strongly advised to include supporting material/evidence. For example, photos, testimonials, reports, figures etc.
  • The winner must be in attendance at the NCSO Professional Development Conference in

Edmonton on March 9 & 10, 2017.

Assessment

  • All applications will be assessed by a panel comprised of representatives from both the U of A and ACSA
  • Scoring for each question will be allocated using a rubric system
  • The short essay will be evaluated based on original thought, practical application, innovation and references to safety applications/best practice

Applications close on Friday February 17, 2017 at 4:00pm.

Should you need assistance with your nomination, please contact or call us at 1.800.661.ACSA (2272).

Name:Click here to enter text.
Company (if applicable):Click here to enter text.
Position (if applicable):Click here to enter text.
Address:Click here to enter text.
City:Click here to enter text.Province:Click here to enter text.
Postal code:Click here to enter text.
Email:Click here to enter text.
Phone:Click here to enter text.
Date of Birth: Click here to enter a date.

Date of NCSO certification:Click here to enter a date.

Are you a member of a Regional Safety Committee? If so, please select which one from the drop down list:Choose an item.

Describe a safety initiative you took part in or implemented while working in the field/on a site; what outcomes did this initiative achieve?Click here to enter text.

Describe some characteristics of an effective manager and/or leader? Which characteristics do you possess? Outline an example of how and when you demonstrated these characteristics. Click here to enter text.

SHORT ESSAY (500 words)

Please outline what it is about the University of Alberta’s Occupational Health and Safety Certificate that interests you? How do you feel this certificate will benefit you?

Click here to enter text.

Thank you for completing this application for the Gary Wagar NCSO Scholarship.

Please attach any additional information or supporting material to this nomination form and email it all together to .

You will be notified of your result in writing in late February 2017.

Permission

In the interest of sharing corporate knowledge, I give permission for the key points of my application to be shared publically should I win.

Yes:☐

No:☐