Application Must Be Made with This Bursary Application Form, Completed in Detail

BURSARY APPLICATION

ELIGIBILITY

To be awarded to a member or a child, grandchild, step child or child of legal guardianship of a member or deceased member of CUPE Local 855 & 855.1.

Application must be made with this Bursary Application Form, completed in detail.

The applicant must be a student in a publicly funded secondary school in the school year in which the application is made.

Provide proof of application of Full-Time registration to a publicly funded post-secondary college or university program or an apprenticeship program that includes an academic portion offer through a college.All awards are made conditional upon the recipient being enrolled in the program for which the award is being requested and proof of completion of first semester or equivalent in the case of an apprenticeship program. The money will be held in trust by the Union until such time as the recipient provides proof of completion of first semester. (Provide a letter of acknowledgement from the post-secondary school).

Applicant acknowledges that if they do not attend school to further their education in the calendar year of the bursary being granted, that the bursary shall be returned to CUPE Local 855 & 855.1.

SUBMIT APPLICATIONS TO:

CUPE LOCAL 855

PO BOX 255,

LINDSAY, ON

K9V 4S1

APPLICATION DEADLINE IS:

MARCH 31ST, 2017

BURSARY APPLICATION

NAME: ______

(Last Name)(First Name) (Middle Initials)

ADDRESS: ______

CITY: ______PROVINCE: ______POSTAL: ______

PHONE #: ______WORK PHONE #:______

E-MAIL ADDRESS: ______

GRADE 12 TRANSCRIPTS OR COPY OF LATEST GRADE 12 REPORT CARD:

______

PROOF OF APPLICATION TO POST SECONDARY INSTITUTIONS & PROGRAMS:

______

NAME OF MEMBER, PARENT OR GUARDIAN (CUPE 855 MEMBER):

______

EMPLOYER & POSITION OF CUPE 855 MEMBER:

______

Please attach all documentation to your application

SHORT ESSAY QUESTION

Please attach ONE page (double spaced, 12pt font) answering ONE of the following questions:

1)Describe the key social and economic issues affecting working people in Canada at the moment.

2)If you were to head a campaign to promote change in Canada, what would your issue and platform be?

I certify that all the information to be true and to the best of my knowledge. I acknowledge that I have read and agree to the terms of the Bursary Application.

______

(Signature) (Print Name) (Date)