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					                                          Bursary Program Application Form


The Bursary is paid out over a one-year period to recipients. Taxes are not deducted by Serve!.
It is your legal responsibility to report the earnings on your yearly tax return.

Please carefully read over the Serve! Bursary Program Information & Guidelines for criteria
and expectations. If you are unsure about your eligibility, have questions about preparing your
application, or have a proposal/initiative outside of the established bursary guidelines, please
consult with Serve! prior to working on your application/proposal. It is your responsibility to
ensure that your application is complete (including necessary attachments).


                                   PERSONAL INFORMATION

Applicant Name: ____________________________________                      Current Age: _________
Serve! Program You Completed: _________________________________
Year You Completed Serve! Program: ____________________
Your Date of Birth: ________________________

Phone Number: _________________________                E-mail: ____________________________
Full Mailing Address: __________________________________________________________
____________________________________________________________________________



                          BURSARY APPLICATION INFORMATION

1. Total Bursary Amount You Are Applying For: ____________________________
2. Have you received a Serve! (or formerly Serve Canada) bursary before? Yes No
       Applicants cannot be a past Serve! (or formerly Serve Canada) bursary recipient.
3. Have you completed high school or received a G.E.D.? Yes              No
        Please attach proof of high school/G.E.D. completion
        (or enrolment in post-secondary education as a mature student).

4. Do you have a valid Social Insurance Number (S.I.N.) card? Yes No
     Bursary recipients must be legally entitled to receive funds and have a valid SIN card.
5a. Please check which of the following you plan to use the Serve! bursary for:
        Plan A: attending full-time post-secondary education
        Plan B: starting your own business initiative or community project
        Plan C: pursuing vocational training
        Plan D: establishing yourself in the workplace
        Plan E: educational travel
        Please consult with Serve! if unsure of categories.

Serve! Bursary Program Application Form       Deadline: May 5, 2008               Page 1   of 5
5b.
        If your are applying for Plan A, C, or D, please provide a 1 – 2 page description of your
        plan for the bursary (please provide as much detail as possible) and attach documentation
        or confirmation of your plan (i.e. registration for school or information on job
        offer/opportunity). Include specific information on steps and timeframes of your plan
        within the one year.

        If you are applying for Plan B, please provide and attach a detailed proposal and
        description (4 – 8 pages) outlining specific goals, activities and steps, timeframes,
        contacts and partners you have established (what is their involvement in project?), etc.

        If you are applying for Plan E, please refer to specific guidelines for educational travel
        and attach a proposal (2 – 4 pages) outlining goals you plan to achieve, what you plan to
        learn, how the experience would be educational, activities you will engage in,
        timeframes, and attach documentation of travel plans and arrangements (i.e. plane ticket,
        acceptance to a program, etc.).


6. What do you need to do to make your plans happen? What has been done already?




7. Please comment on your financial need and provide an outline of current sources of income
   and financial support.




Serve! Bursary Program Application Form      Deadline: May 5, 2008              Page 2   of 5
8. How can the Serve! bursary help you with your plans?




9. The Serve! bursary is intended to assist you in achieving your goals and is not the only
   source of support. What steps have you taken to secure other sources of funding to help
   you reach your goals? (include information on other bursaries, scholarships, financial aid you
   have applied to or will be receiving).




Remember: the bursary will be distributed to recipients in instalments and Serve! will need to
receive information/documentation as well as at least 3 reports over the year from recipients to
confirm that they are following their plans.

                             LONGTERM GOALS AND PLANNING

10. Please tell us how your plans for the year ahead will contribute to the improvement
    of your personal stability and future goals (how will the opportunity impact your longer term
    future?).




Serve! Bursary Program Application Form     Deadline: May 5, 2008              Page 3   of 5
                    COMMITMENT TO SERVE!’S MISSION & VALUES

11.     a) Describe the activities that you have undertaken to further your personal
        development, teamwork, and community involvement.




        b) What activities do you plan to undertake to further your personal development,
        teamwork, and community involvement? (may or may not be part of your bursary plan)




12. What did you gain from your involvement in Serve! (formerly known as Serve Canada)?




13. What are some ways you will give back to Serve! and other youth participants if you
    are a bursary recipient (i.e. delivering a workshop for youth, speaking about your experience
    and achievements at special events, contributing to youth outreach, or other creative/useful
    help)?




Serve! Bursary Program Application Form     Deadline: May 5, 2008              Page 4   of 5
                                      LETTERS OF SUPPORT


We would like to hear from one or two other people who are in support of your application.
Please attach 1 – 2 letters of support (not from family members, friends, or Serve! staff). This can
be from a teacher, supervisor, social worker, counsellor, coach, etc.




                                  APPLICATION CONCLUSION

If you are selected as a bursary recipient, would you be willing to be identified as a recipient
(have your name printed) in Serve! communication and promotional material?
        Yes      No




___________________________                              ________________________
    (Signature of applicant)                                 (Date of application)


Thank you for applying! Your application will be reviewed by Serve! staff and the Program
Committee. NOTE: You may be asked to give more information. You will be informed of the
outcome of your application approximately 4 weeks after the application deadline.




Serve! Bursary Program Application Form         Deadline: May 5, 2008             Page 5   of 5

				
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Description: download the application form (word)