Application Form YKDFN De Beers Scholarship

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Application Form YKDFN De Beers Scholarship Powered By Docstoc
					        YELLOWKNIVES DENE FIRST NATION / DE BEERS CANADA INC.


                                   Scholarship
                                  APPLICATION FORM
Name: __________________________________________

Permanent Address: ___________________________________________________________

Present Address: ______________________________________________________________

Phone: _________________      E-mail Address: _____________________________________

Treaty Number: _______________

Post-Secondary Institution: ______________________________________________________

Field of Study: ______________________________

Year of Study:         ____1st ____ 2nd ____ 3rd ____ 4th ____ Post Graduate

Total Number of Courses Enrolled in: ______

Total Courses Completed: ________________

Financial Support: ___Student Financial Assistance         Amount___________________
(Please Specify)   ___ Pathways                            Amount___________________
                   ___ Other Funding Source                Amount___________________

What type of employment are you interested in? ____________________________________


                   This Space for YKDFN-De Beers IBA Committee Use Only

                       Approved                                   Not Approved


_________________________         _________________________        Date: ______________
YKDFN Committee Member             DBCI Committee Member


Send application to:   YKDFN/De Beers Representative
                       Yellowknives Dene First Nation
                       BOX 2514
                       Yellowknife, NT X1A 2P8
                       Tel: (867) 873-9829  Fax: (867) 873-9831
                       E-mail: splotner@ykdene.com

				
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