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A $1,000 bursary will be awarded to a full time student, including freshmen, pursuing any course of study, at a University, College or School of Higher Learning.
Applicants Name
Applicants Email
Applicants Contact Number
Mailing Address
Parents / Guardians Names
Mother’s name and occupation
Father’s name and occupation
Parents Address is different from the applicant
Name of the insurance brokerage you are associated with
Names and ages of any other dependents in your household
Educational Information
Which educational institution did you attend in the last academic year?
Which educational institution will you be attending in the next academic year?
What studies have you completed - year/faculty?
Tell us a little bit about yourself
Help us get to know you, please provide a short profile of your chosen field of studies and career objectives
What have you done, above and beyond schooling, tell us about any special studies, work experience, volunteering to support your application
Did/do you hold any outside interests, organizations or office positions that would help support your application?
Please share names and email addresses where available, of three (3) individuals who may be contacted as references. Two (2) of these references must be from academic sources familiar with your studies.
Help us understand your financial resources for the Year
$$ Financial resources for the year - This can be from summer employment, to help with your academics this fall
Do you have any other financial resources for the year - From Canada Student Loan and Government Bursary Programs? If so, how much $
Any financial resources for the year - From other sources (parents, relatives, etc.), if so, how much $
Any other financial resources for the year - From scholarships/bursaries already received, if so, how much $
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