CALGARY LITHUANIAN CULTURAL SOCIETY

APPLICATION FOR POST-SECONDARY SCHOLARSHIP

Name: ______

Address: ______

Telephone Number:______E-Mail:______

I hereby apply to receive a scholarship from the Calgary Lithuanian Cultural Society to assist me to achieve a post-secondary education. I plan to pursue a course of studies at ______(name of Institution), located at ______(City, Province or State, Country), leading to a Diploma/Certificate/Degree in ______.

What is your year (or anticipated year) of graduation from high school?______

What is the name and address of your High School?______

If you have completed some studies at an accredited Post-Secondary Institution, please provide the name and address of that institution ______
______

In what year did you complete those post-secondary studies? ______

What program of studies were/are you pursuing?______

If you have participated in Community Service activities, please provide details, including the time period in which you performed them. ______

______
______

How have you contributed to your community through Leadership functions? Please provide details and indicate the time period in which you carried out those activities.

What sports do you regularly participate in? Are you a member of any organized sports team? ______

Are you a member in good standing of any Canadian Lithuanian Community organization? Please indicate what organization and how long you have been a member.

Have you participated in any activities organized by a Canadian Lithuanian Community organization? Please describe the activities and indicate the time period in which you participated.______

______.

______

Signature Date of Application

Please Enclose:

·  A 700-word essay that you have composed on the topic of “Cultural and environmental interfaces and similarities between Alberta and Lithuania”

( if submitting by mail, please provide three copies)

·  If you are currently enrolled in high school, please provide a coy of your most recent report card

·  If you have already completed a portion of a post-secondary program of studies, please include a copy of your most recent transcript of marks

·  Proof of your acceptance into a course of full-time studies leading to a diploma, certificate or degree at an accredited post-secondary institution

PLEASE NOTE: ONLY PHOTOCOPIES SHOULD BE SUBMITTED, AS NO DOCUMENTS WILL BE RETURNED TO APPLICANTS