Candidate No. _______(Legion personnel to fill)

The Royal Canadian LegionOnaping Falls (Branch 503)

3 St. James StreetOnaping, Ontario

Mailing addressBox 621, Levack, Ontario

POM 2CO

ATTACHMENT TO BURSARY APPLICATION

Also to be completed by the Candidate

NAME : _____________________________________

ADDRESS : _____________________________________

_____________________________________

PARENT/GUARDIAN NAME : _____________________________________

Candidate No. _____

THE ROYAL CANADIAN LEGIONONAPING FALLS BRANCH /503

BURSARY APPLICATION

ALL QUESTIONS MUST BE ANSWERED

1. I am a resident of Onaping Falls or Cartier. YES □ NO □

2. I am currently enrolled at : _______________________________ (school)

3. (a) My Mother/Father/Grandparent is/was a member of the Canadian Armed Forces. YES □ NO □

If yes, specify details : ________________________________________________________

4. (a) Are you related to a member of the Royal Canadian Legion? YES □ NO □

(b) If yes, specify details : ________________________________(Name of relative / relationship)

5. As a graduate of a secondary school, I have applied to the following Post-Secondary Institutions:

Institution Program

1st Choice

2nd Choice

3rd Choice

6. My course of studies at the Post-Secondary Institution will commence: _________________, 2014.

Candidate No. _____

7. Check mark the appropriate boxes to indicate the number of persons totally dependent on your Parents or Guardians.

Brothers

&

Sisters

Age (in

years)

Elementary Secondary Post-

Secondary

1

2

3

4

8. My Household’s gross income this year will be approximately: please include both parent’s income (Line 150 on Income tax) TOTAL = $________

9. My expected summer income will be approximately: $___________________

10. Candidate’s final overall average mark Semester I: ________________

Candidate’s mid-term overall average mark Semester II: _______________

11. School Official’s comments

__________________________________________________________

__________________________________________________________

__________________________________________________________

__________________________________________________________

__________________________________________________________

__________________________________________________________

**NOTE** Successful candidates will be issued their Bursary upon proof of Registrationin a post-secondary institution.. This application must be submitted to your school Guidance Office for confirmation of marks and additional comments. Please return completed application to Branch 503 by April 30th, 2014.