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Kinsmen Club of Stony Plain Bursary Application Form

Kinsmen Bursary Application First Name:

Middle Initial:

Last Name:

Address:

City or Town with Postal Code:

Proposed Program of Study Name of Institution:

Program:

Start Date:

Completion Date:

Certificate or Degree Expected:

Which year of your program will you be entering:

Estimated expenses for the year:

Personal Background Extra-curricular activities:

Community Service & Volunteer Activities:

Work Experience:

Outline briefly your plans for your future career and how this bursary would assist you:

Please comment on your knowledge or experience of Kin Canada or The Kinsmen Club of Stony Plain:

List any additional information which you feel is important for consideration by the committee:

Date:

I hereby certify the above information is correct and can be verified on request; and that I have not been a recipient of this bursary previously.
I agree

Visitor Confirmation

please enter the letters as they appear