Chester Basin-New Ross-Chester Lions Club

Application for Bursary

 

Two bursaries in the amount of $500 each may be awarded each year. A graduating student may apply if he/she resides in the area served by the CBNRC Lions Club, or is from our area and has transferred to another school, or is is a graduating student living in Nova Scotia and is a child or grandchild of a CBNRC Lion. Applications are to be submitted by May 30th.

Name of Applicant:_________________________________________ Age:________

Parent(s) or Guardian(s):_________________________________________________

Address:______________________________________________________________

Name of School:________________________________________________________

Occupation of Parent(s) or Guardian(s): Father________________________________

                                                                 Mother________________________________

Name of University or College you plan to attend:______________________________

Brief description of the program:____________________________________________

 ______________________________________________________________________

How do you plan to finance your education:____________________________________

______________________________________________________________________

 

Other relevant information: hobbies, special interests, extra curricular activities:_______

 

 

Please attach an official transcript from your Guidance Counsellor showing final marks for grades X and XI, as well as term marks for grade XII

 

Date:_____________       Applicant’s Signature:_______________________________

 

Date:_____________       Guidance Counsellor’s Signature:______________________

 

 

Date Received:__________________ Chairperson’s Signature:____________________

 

Revised 2004