Bursary Application Form – Hellenic Ladies Benevolent Society

Which bursary are you applying for? *

Academic
Vocational
Sports
Arts

Do you have, or will you have, funding from other sources for this type of training? *

Yes
No

If YES, please state the source of the funding:

Required if you selected "Yes". Failure to fill in this section may affect the committee's final decision.

If you selected OTHER as the source of funding, please specify:

Required if you selected "Other". Failure to fill in this section may affect the committee's final decision.

Please state the amount (CAD$) of the funding:

Name: *

First

Last

Date of Birth: *

mm/dd/yyyy

Email: *

Email

Confirm Email

Home Address: *

City: *

Province: *

Postal Code: *

Country: *

Telephone Number: *

Dependents: *

Yes
No

Example: Children, elderly parents, etc.

Number of Dependents:

Required if you selected "Yes". Failure to fill in this section may affect the committee's final decision.

Marital Status: *

Are you employed? *

Yes
No

Total Annual Gross Income (CAD$):

Required if you selected "Yes". Failure to fill in this section may affect the committee's final decision. Evidence must be uploaded at the end of the application.

Name of Employer: *

Required if you selected "Yes". Failure to fill in this section may affect the Committee's final decision.

Workplace Address (street, city, province, postal code, country):

Required if you selected "Yes". Failure to fill in this section may affect the committee's final decision.

Are you a student? *

Yes
No

If you are a MINOR, please have your parents or your legal guardian complete the section(s) below.

Mother's Name:

First

Last

Home Address:

City:

Province:

Postal Code:

Country:

Citizenship:

Telephone Number:

Email:

Email

Confirm Email

Maritual Status:

Is she employed?

Yes
No

Total Annual Gross Income (CAD$):

Required if you selected "Yes". Failure to fill in this section may affect the Committee's final decision. Should you be short-listed, you will be asked to provide proof of gross income.

Name of Employer:

Required if you selected "Yes". Failure to fill in this section may affect the committee's final decision.

Workplace Address (street, city, province, postal code, country):

Required if you selected "Yes". Failure to fill in this section may affect the committee's final decision.

Is she a student?

Yes
No

Father's Name:

First

Last

Home Address:

City:

Province:

Postal Code:

Country:

Citizenship:

Telephone Number:

Email:

Email

Confirm Email

Marital Status:

Is he employed?

Yes
No

Total Annual Gross Income (CAD$):

Required if you selected "Yes". Failure to fill in this section may affect the Committee's final decision. Should you be short-listed, you will be asked to provide proof of gross income.

Name of Employer:

Required if you selected "Yes". Failure to fill in this section may affect the committee's final decision.

Workplace Address (street, city, province, postal code, country):

Required if you selected "Yes". Failure to fill in this section may affect the committee's final decision.

Is he a student?

Yes
No

Guardian's Name:

First

Last

Home Address:

City:

Province:

Postal Code:

Country:

Citizenship:

Telephone Number:

Email:

Email

Confirm Email

Marital Status:

Is he/she employed?

Yes
No

Total Annual Gross Income (CAD$):

Required if you selected "Yes". Failure to fill in this section may affect the Committee's final decision. Should you be short-listed, you will be asked to provide proof of gross income.

Name of Employer:

Required if you selected "Yes". Failure to fill in this section may affect the Committee's final decision.

Workplace Address (street, city, province, postal code, country):

Required if you selected "Yes". Failure to fill in this section may affect the Committee's final decision.

Is he/she a student?

Yes
No

ABOUT YOUR STUDIES: Which term(s) are you applying for?

Educational Institution:

Studies:

Which year of studies will you be entering? (First year, last year, etc.)

Field of Study

Duration of studies (ex. one semester, one year, etc.) this bursary will cover:

Faculty/Department:

Major:

Number of terms:

Selected Value: 1

Assuming each year is 3 terms (fall, winter, summer)

If this application pertains to a SPORT, please identify the type of Sport:

Describe your past Involvement in this Sport:

Institution:

Program:

Year(s):

If a team sport, indicate position you will play:

First/Last Name of Coach:

Name of Educational Institution or Sports Association:

Tuition/Training Fees per season:

If this application pertains to the ARTS, please select the discipline:

Institution:

Program:

Year(s):

First/Last name of Mentor/Instructor:

Supporting Documents Checklist- Should you be short-listed and invited to an interview, you will be asked to show originals or certified copies of the documents below. Please ensure that you have them.

Birth Certificate or Copy ID/Passport
Medicare or driver's license
Proof of Greek descent (ex. Birth Certificate of Greek parent or Greek grand-parent)
Proof of Total Annual Gross of Applicant (i.e Income Tax Assessment)
Proof of Total Annual Gross of parent or guardian if applicable (i.e Income Tax Assessment)
Monthly Budget (income & expenses)
Proof of Studies/ Training

(Ex. Academic Transcripts, Letter of Admission, Sports or Arts Membership, etc.)

LETTER OF INTENT -Please explain your reasons for studying/practicing your chosen field and indicate your future aspirations. (Max. 300 words)

IF YOU HAVE ANY QUESTIONS, PLEASE EMAIL US AT: bursary.hlbs2@gmail.com