Lord Byng Secondary School: Scholarships/ Bursaries / Awards Application Due Date: April 5 th, 2018, 3:30pm to Ms. McKay (must be handed to her personally, signed in and time stamped) 1. Applicant Information Name: Student Number: PEN: Date of Birth: Place of Birth: Canadian citizen or Permanent resident: Mailing : City / wn: Postal Code Phone Number: Email : 2. Educational Information High School Courses: List ONLY courses completed or being completed at Lord Byng in grade 11 and grade 12. Courses 2016/2017 Final Grades % Courses 2017/2018 Grades (%) Term1 Grades (%) Term 2 Future Plans: List the Post-Secondary Institutions you are considering in order of preference. Institution Program Name Program Length 1. 2. 3.
Career Interests: List career options that you are considering. Specify uncertain if you have no idea at this time. 1. 2. 3. Academic or Career Examples: Culinary Arts/ Humanitarian/ Law/ Trades/ Literature/ Education/ Music / Fine arts/ Acting/ Business / Medical / Sciences / Engineering/ Info.Tech/Nursing / Entering Workforce / Gap Year / Travelling / etc. 3. Awards and Distinctions List up to 4 Awards or Special Recognitions that you have received. (i.e. Honor Roll, certificates, competitions etc.) and the year that they were awarded to you. 1) 2) 3) 4) 4. Activities Fine Arts and Athletics: List all significant artistic and athletic involvement in the school or the community. (i.e. Theater, School Team, Symphony, etc.) Grade (Ex: lead violinist, stage manager, team captain) Fine Arts or Athletic Involvement (specify School or Community) and Coach/director/conductor/etc. School Service: List all significant school activities in which you have participated in from grade 10 to grade 12, (i.e. clubs, student council, etc.) Please list in order of commitment. Grade # of hours to date Club /Activity, Responsibilities and Sponsor teacher
Community Service Hours Community Service refers to service that a person performs for the benefit of her or his local community. Community service is unpaid and does not count towards academic/school credit. Community service can help any group of people in need: children, senior citizens, people with disabilities, English language learners, and more. It can also help animals, such as those at a shelter, and it can be used to improve places, such as a local park, garden or forest. Community service is often organized through a local group, such as a place of worship, school, or non-profit organization. You can also start your own community service projects. Common community service examples include: Working with schoolchildren: Tutoring children after school (unpaid), collecting school supplies to donate, planting a school garden. Working with senior citizens: Visiting residents of a retirement center (visit, read, play cards or board games, take seniors for walks, crafts), delivering meals to senior citizens, driving them to appointments. Provide service to seniors or to others who have difficulty leaving their homes raking, lawn cutting, shopping, visiting, reading, meal preparation Improving the environment: Holding a recycling contest, planting trees, creating a new trail at a nature center. Take part in environmental initiatives cleaning and recycling operations, park clean-up, planting Helping low-income people: Passing out food at a soup kitchen, collecting used clothes to be donated, making first aid kits for homeless shelters. Help organize local community events food drives/banks Get involved in charitable activities walk-a-thons, daffodil sales, canvassing for organizations, volunteer in leadership role with community groups youth groups. Volunteer in hospitals, libraries. Volunteer with social service or animal welfare agencies, Red Cross, United Way, Humane Society Community Service and Volunteer Experience Please fill out your outside of school, non-paid, community service/volunteerism history, up to a maximum of 3. Leave this section blank if you do not have community service or outside of school volunteer experience. Please ensure contact information is current. Contact persons and supervisor may be contacted. First contact reference Student Name Student Number Month / Years tal Hours Second contact reference if applicable Month / Years tal Hours Third contact reference if applicable Month / Years tal Hours
For the following section), please select the community service/volunteer experience that was most meaningful to you or in which you feel you had the most impact. Brief Description of Service: (What was your role? What difference did you make? What were your responsibilities? Why did you volunteer with this organization? What did you learn? How did you contribute to the overall success of the organization?)
5. Work History (Do Not include hours from Lord Byng s Work Experience class with Ms. Whelan) A. Do you work part time during the school year? B. Do you work during the summer? Please list work history in recent order 6. Financial Need and Special Consideration A. Are you currently in a position of financial need? B. Do you wish to be considered for an award based on any special circumstances that have challenged you? (i.e. learning disabilities, illness, grief, etc.) Yes No If yes, please explain your circumstances. Student Signature Date