2018-2019 University Program

RECRUITMENT BURSARIES

Name : ______Sport : ______

Under which category of the 2018-2019bursary program are you applying?

RECRUITMENT BURSARY FOR QUEBECERS

RECRUITMENT BURSARY FOR CANADIAN(NON QUEBECERS)

PROCEDURE

  1. Read the information on the Foundation and its bursary program (pamphlet, objectives, and eligibility criteria).
  1. Complete the bursary application form and send it, along with a copy of your transcripts (college and high school)by emailto the following address :

E-mail:

  1. Deadline for sending an application for entrance bursaryfor Canadian (non-Quebeckers) andfor sending an applicationfor Quebecers isFebruary 23, 2018. Please include in the subject line OUT OF PROVINCE RECRUITMENT BURSARIES 2018/YOUR NAME

GENERAL INFORMATION

Last name: Date of Birth:

First name: Social Insurance Number:

Sport: E-mail:

Sex :FemaleMale

CURRENT ADDRESSPARENTS ADDRESS(If different)

No, Street, Apt.No, Street, Apt.

City & ProvinceCity & Province

( ) ( )

Postal Code Home PhonePostal Code Telephone

()

Cell phone

INFORMATIONS ON THE BURSARY DEMAND

AND ON FINANCIAL SUPPORT

Are you or have you ever been a member of a Provincial or National level team (Team Québec, Team Alberta, Team Canada etc...)?

ProvincialYesNo

National:YesNo

If so, when and for what competition:

Year: Competition:

Are you identified by your provincial federation as an athlete of one of these categories ?

Hopeful Elite Excellence

Do you receive financial support from other sources?

YesNo

If yes, from whom?

Source(s):Amount(s):

ATHLETIC CAREER INFORMATION

YEAR / TEAM OR CLUB / COACH
2016-2017
2017-2018
2018-2019***

*** Please provide your prospective university. If there are multiple universities that you are considering, please include the top 2 or 3.

BEST ATHLETIC PERFORMANCES

DATE / NAME OF COMPETITION / PLACE / RANK / PERFORMANCE

*** Include stats or times whenever possible/pertinent

SPORTS AWARDS RECEIVED

(not mentioned previously)

DATE / NATURE

2018-2019 ATHLETIC OBJECTIVES

ACADEMIC INFORMATION

YEAR / INSTITUTION / MAJOR / DIPLOMA
2016-2017
2017-2018
2018-2019**

*** Please include all prospective universities and programs

Will you be a full-time student in September 2018?

YesNo

If not, explain why?

Did you receive honour or distinctions for your academic performances?

YesNo

DATE / HONOURS

N. B. : Enclose a copy of your College or Highschool transcript -MANDATORY