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					                                                  MERIT AWARD BURSARY
                                                        2008 APPLICATION FORM
Criteria for Award

A successful applicant:

1.   Must be currently enrolled in high school as a full-time student for the school year 2007-2008 OR as a full time-student during Semester 1 or
     Semester 2 of the school year 2007-2008;
2.   Must intend to return to school as a full-time student, in the 2008-2009 school year, in Grade 12 or postsecondary education at the university or
     college level, including registered apprenticeship programs;
3.   Must demonstrate dedication to schoolwork;
4.   Should demonstrate a high level of commitment to extracurricular school activities; and
5.   Should demonstrate a high level of commitment to volunteerism in the community at large.

Please note:
1. Personal challenges and obstacles faced by the applicant, including financial circumstances, will be given significant consideration.
2. Contributions to family welfare by the applicant will be considered.
3. Work experiences of the applicant will be considered.

In order to receive a Merit Award Bursary
1. Student recipients must be enrolled as a full-time student at high school or in university or college for the school year 2008-2009.
2. The bursary will be paid in the Fall of 2008 after the student provides written confirmation of their attendance at high school or a postsecondary
     institution.

Please complete all sections of the application form. Please type answers if possible. Electronic versions of this
form are available at http://www.meritaward.ca, or may be available on your school’s website or guidance office.

Name:                                                                                            Grade:
Address:
                                                                                                 Postal Code:
Telephone:        Home:                             Email
                  Cell:                             address:                                     School:

a) List any extracurricular activities, including teams, clubs or activities, that you participate in at school:




b) List any activities, including teams, groups or work commitments that you participate in outside of school: If you
work part-time state, on average, how many hours per week that you work. [Note: Community volunteer activities are
dealt with separately in the next question (c).]
MERIT AWARD BURSARIES – 2008 APPLICATION FORM                 Page 2




c) List your volunteer work in the community at large that you have completed. In this section you may also describe
   how you have contributed to your family’s welfare.




d) Describe your best accomplishments in the activities outlined in parts (a), (b) and in (c). Explain how you have
   shown a high level of commitment to those activities.




e) State your educational goals:




f) State your career goals:




g) Personal challenges or obstacles that you have overcome, including financial circumstances, will be considered.
   Describe any such personal circumstances that you want the Selection Committee to consider.
MERIT AWARD BURSARIES – 2008 APPLICATION FORM                                Page 3




h) You must supply references from two teachers: One reference regarding your schoolwork and one reference
   regarding your other activities. State the names of the two teachers who will complete these references.
PLEASE NOTE: Teachers may substitute a letter of reference for the Teacher Reference form. In the letter of reference
   they should make sure that they cover each section as outlined in the Teacher Reference Form. Teachers may hand in
   their completed reference forms directly to the Merit Award Bursary Committee at your school.
    Teacher Reference 1                      ACADEMIC – Teacher’s Name



    Teacher Reference 2                      ACTIVITIES BEYOND THE CLASSROOM – Teacher’s Name



Optional: You are encouraged to provide one additional reference letter from a non-teacher. If you are doing so, provide the
following information about that person:
Reference Name:                                                                       Phone:
Address:
Relationship to you:

YOUR BURSARY APPLICATION WILL BE EVALUATED BASED ON YOUR COMPLETED APPLICATION, YOUR MARKS, YOUR
REFERENCES AND YOUR PRINCIPAL’S RECOMMENDATION. MAKE SURE THAT YOUR APPLICATION IS COMPLETE.


The undersigned student hereby applies for a Merit Award Bursary. I hereby give permission for my school to release my marks for the current
school year and my current transcript (including prior year’s grades) together with evaluative information to the Merit Award Bursary Program
Selection Committee (“the Committee”). I understand that some bursaries may be funded by the Kiwanis Club of Toronto (“Kiwanis”), and I hereby
authorize the Committee to provide this application and the supporting information provided by my school to Kiwanis if I am selected for one of the
bursaries it funds. I confirm that I intend to return to school for the school year 2008-2009 as a full-time student in Grade 12 OR at the
postsecondary level in a university or college program, including a registered apprenticeship program.


Applicant’s Signature                                                                          Date

NOTE: This completed application form should be handed in to the Main Office or Guidance Office at your school by April 25, 2008. Your
application, letters of reference and transcript will then be forwarded to the Merit Award Bursary Selection Committee.
                                                                                                                                     elm #7257989 v.1
                    TEACHER’S REFERENCE – MERIT AWARD BURSARY – ACADEMIC
                                                     [Please Type]
                                APPLICANT’S NAME: ____________________________

1. How long have you known the applicant?
2. What courses have you taught the applicant?


3. Describe how the applicant has demonstrated a high level of commitment to his or her school work:




4. Do you have any other comments regarding the applicant you wish to bring to the attention of the Selection
   Committee (e.g. the applicant’s extra-curricular activities or personal circumstances)?




I, _____________________(print teacher’s name) recommend ________________________ (print student's name) for
one of the 2008 Merit Award Bursaries.


                                    ______________________________
Teacher’s Name (Please Print)       Teacher’s Signature                Date
    TEACHER’S REFERENCE– MERIT AWARD BURSARY - ACTIVITIES BEYOND THE CLASSROOM
                                                       [Please Type]
                              APPLICANT’S NAME: ____________________________

1. How long have you known the applicant?
2. List any extra-curricular activities in which you directly supervised the applicant:




3. Describe how the applicant has demonstrated a high level of commitment to activities beyond the classroom:




4. Describe any contributions the applicant has made to the welfare of the community, including family responsibilities,
   of which you are aware:




5. Do you have any other comments regarding the applicant or the applicant’s personal circumstances that you wish to
   bring to the attention of the Selection Committee?




I, _____________________(print teacher’s name) recommend ________________________ (print student's name) for
one of the 2008 Merit Award Bursaries.



Teacher’s Signature                                                      Date
                                                                                                          elm #7274546 v.1

				
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