Event Calendar

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A printable copy of this document can be downloaded at the bottom of this page.

The Orillia Fish And Game Conservation Club

P.O. Box 52, Orillia, Ontario L3V 6H9

The Leatherdale and Other Deceased Members Bursary

 

Application Form 2015 Print carefully. Illegible or incomplete forms will not be considered. If more space is needed, use the back.

Name

_____________________________________________

Date Of Birth

_______________

Surname

First

Middle

 

Day/Month/Year

 

Address

___________________________________________________________

Postal Code

_____________

Telephone

___________________________

Names of parents or Legal Guardian(s)

___________________________

 

 

 

___________________________

List of Secondary Schools Attended

__________________________________________________________________

From: _______

To:_______

__________________________________________________________________

From: _______

To:_______


All applicants must have completed or are completing their Ontario Academic Credits for High School Graduation at the time of application.
 
Name of College or University where you plan to study.

_______________________________________________________________________________________________

What are your proposed courses of Study?

_______________________________________________________________________________________________

Are you applying for other scholarships? If so, please indicate below.

_______________________________________________________________________________________________


List the Names & addresses of two persons from whom references have been requested. (One must be one of your teachers)

Name

__________________________________

Name

__________________________________

Address

__________________________________

Address

__________________________________

Telephone

__________________________________

Telephone

__________________________________


Briefly describe all types of employment you have held during your summers and during your school terms.

________________________________________________________________________________________________

________________________________________________________________________________________________

________________________________________________________________________________________________

________________________________________________________________________________________________

________________________________________________________________________________________________

________________________________________________________________________________________________

________________________________________________________________________________________________

________________________________________________________________________________________________


Outline briefly your interests or experiences in sports, hobbies, extracurricular school activities and community groups.

________________________________________________________________________________________________

________________________________________________________________________________________________

________________________________________________________________________________________________

________________________________________________________________________________________________

________________________________________________________________________________________________

________________________________________________________________________________________________

________________________________________________________________________________________________

________________________________________________________________________________________________


Briefly outline your reasons for applying for the Leatherdale Bursary and your future plans for employment.

________________________________________________________________________________________________

________________________________________________________________________________________________

________________________________________________________________________________________________

________________________________________________________________________________________________

________________________________________________________________________________________________

________________________________________________________________________________________________

________________________________________________________________________________________________

________________________________________________________________________________________________


How do you feel about the sports of hunting and fishing?

________________________________________________________________________________________________

________________________________________________________________________________________________

________________________________________________________________________________________________

________________________________________________________________________________________________


Date of Application

____________________

Signature of Applicant

_________________________________________

Signature of Parent or Guardian

_________________________________________

Signature of the School Principal

_________________________________________

To be received on or before June 1st, 2015
Download a word document .zip file of this application form by clicking here.