2015 OACAS Youth Scholarship Application
2015 YOUTH SCHOLARSHIP APPLICATION
(Youth 21+)
Application for:
- Clark Bursary ($3,500 per year for up to 4 years maximum)
- Clark Grant ($1,000 one-time)
- RONA/PHD Scholarships ($3,000 one-time)
If you have previously won the Clark Bursary you will not be able to apply again.
Please read and complete the questions carefully. Providing the Award Selection Committee with as much information as possible and quality answers will lead to higher scores.
Save the file name as “LAST NAME, FIRST NAME”
Email and attach a head shot picture of yourself
When completed, email this application to
If possible, copy and paste the reference letter directly into this document. If not, you may email the letter as separate attachment to
Successful nominees will be contacted to the email we received the application from.
1. NOMINEE CONTACT AND GENERAL INFORMATION
2015 OACAS Youth Scholarship Application
a)First Name:
b)Last Name:
2015 OACAS Youth Scholarship Application
c)Main Phone Number:
d)Main Email Address:
2015 OACAS Youth Scholarship Application
e)Date of Birth (MONTH/DAY/YEAR):
f)Current Age:
2015 OACAS Youth Scholarship Application
g)Wardship status (e.g., Crown Ward or Former Crown Ward):Choose an item.
h)Name of Children's Aid Society (CAS): Choose an item.
i)Name of last worker (Please be aware we may contact the agency for verification):
j)Email or phone number of last worker:
2. Please select which awards program you are applying for? (Clark Bursary, Clark Grant, RONA/PHD Scholarship.
Choose an item.
3. Does this application/nomination refer to a youth over 21 years old applying independently?
YES ☐NO ☐
a)Have you previously completed a post-secondary college diploma or university degree?
YES ☐NO ☐
Part 1. FINANCIAL NEED (50%)
4.Demonstrated financial need, debt carried, potential of other supports, scholarships/bursaries
a)Do you intend to apply for the Ontario Student Assistance Program (OSAP)? (Please note, applying for OSAP is required for any of these awards, government grants are available through OSAP)
YES ☐NO ☐
If no, please explain reason:
b)Have you applied for financial assistance other than OSAP (bursaries, scholarships, loans)?
YES ☐NO ☐
If yes, please specify:
c)Does a local Children’s Aid Society provide financial assistance? If yes, please specify amount.
YES ☐NO ☐
d)Are you currently carrying any debt? If yes, please state how much and explain.
YES ☐NO ☐
e)Do you currently have a job? YES ☐NO ☐
f) Have you ever completed a Financial Literacy Training Course?
YES ☐NO ☐
g)Do you plan on finding a summer job? YES ☐NO ☐
h)Do you plan on working while going to school? YES ☐NO ☐
5. Enter any comments about employment here. (Employment history, description of job, roles and responsibilities, and do you like or dislike your job?)
BUDGETING
6. INCOME. Do your best to estimate upcoming income.
a. Estimated savings from summer employment / Amount $b. Estimated income from work during school year / Amount $
c. Continued Care and Support for Youth, or Living and Learning Grant, per month / Amount $
d. Other scholarships or awards / Name of award:
Amount $
e. Other sources of funding (family, government grants, supports, and programs) / Sources of funding:
Amount $
f. Total amount of estimate income during the 8 month period of school / Amount $
7. EXPENSES. Do your best to estimate upcoming expenses.
a. Tuition (total for upcoming school year) / Amount $b. Books and supplies (total for upcoming school year) / Amount $
c. Rent (monthly) / Amount $
d. Estimated food (monthly) / Amount $
e. Transportation (monthly) / Amount $
f. Hygiene (monthly) / Amount $
g. Medical (monthly) / Amount $
h. Entertainment (monthly) / Amount $
i. Other (monthly) / Please list expenses and amount $
j. Total expenses (monthly) / Amount $
Part 2. Potential for Success - 15%
career goals that are realistic to your current academic performance
immediate plans to pursue or is pursuing post-secondary education at: university, college, technological institutions, training institution such as those that provide apprenticeships and skilled trades
Special considerations for unique circumstances such as the following:
satisfactory academic achievements
lower grades, but mitigating circumstances (e.g., learning disability, medical condition, etc.), potential for other scholarships/bursaries
8. Expected education achieved by June this school year?
9. Overall average maintained during most recent school term/semester:
10. Please state briefly about the last semester at school. (250 words maximum) Did you do well, enjoy classes, any challenges?
11. What are your educational plans/goals for next year?
12. Area of planned specialization?
13. What school do you plan to attend this fall?
14. Have you already been accepted in this school? YES ☐NO ☐
15. What would you like to do after you finish your program? Career goals? (Maximum 250 words).
Part 3. Contribution to the community (15%)
Extracurricular activities, sports, clubs, volunteer work, involvement in family/community, advocacy work, passions, interest, and causes.
16. Doyou…
a)Participate in any extracurricular activities? If YES, Please specify. YES ☐NO ☐
b)Volunteer for any group, organization or facility? If YES, Please specify organization and estimated hours accumulated. YES ☐ NO ☐
17. Please detail any family or community involvement.Maximum 500 words. (Extracurricular activities, sports, clubs, volunteer work, involvement in family/community, advocacy work, passions, interest, and causes.) What were your roles and responsibilities, how was the experience, what are you interested in, what would you like todo in the future?
Part 4. Personal story (15%)
Personal qualities, challenges overcome in life, family support, skills, and leadership qualities.
18. Why do you think you should be selected for this award? Maximum 500 words.(Ex. overcoming challenges, community involvement, accomplishments, goals, skills, passions, ambitions, etc.)
19. PERSONAL REFERENCE CONTACT AND GENERAL INFORMATION
A reference can be an employer, teacher, neighbor, and family relative, worker (current or former). Ideally the reference is different from the person completing question #22.
Reference first and last name:
Reference relationship to nominee:
20. GENERAL REFERENCE LETTER - Please attach a general reference letter from the person listed in question #19. You may copy and paste the letter below if possible. If not, you may send the letter as a separate attachment by email with this application.
You can comment on your relationship with the nominee, skills, character, experience, academic potential, growth, and challenges.
21. Please include a short biography (4-6 sentences) about yourself written in the 3rd person. (Name, school, studies, interest, future, etc.) The purpose is to provide a brief snap shot of the youth for the awards ceremony in event they are selected for the award.
CHECK LIST REMINDER:
Save the file name as “LAST NAME, FIRST NAME”
Please attach a headshot picture of the yourself
When completed, email this application to
If possible, attach reference letter directly into this document. If not, you may email the letter as separate attachment to
Successful nominees will be contacted to the email we received the application from.
IF SUCCESSFUL, winners will need to complete the following:
Complete general contact form
ProvideSocial Insurance Number
Banking information for direct deposit (institution #, transit #, account #)
Thank you card mailed addressed to specific award
Send confirmation of enrollment/timetable immediately once they receive it from their school once in the Fall and once in the Winter semesters