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Bursary Awards Application

Live Forms

Applicants Information
First Name
Last Name
Date of Birth
Month - Day - Year
Address
City or Town
Postal Code
Email
Phone
Phone Number
Preferred Method of Contact

Email Text Phone
Current & Past School or Institution
Schools physical address
What year of Secondary Education are you currently in?
GivePermission

I hereby grant permission to the Devon General Hospital Foundation Bursary Committee to contact my secondary school to request further information about me if they see fit.
Agree T4

A T4A will be issued to all individuals who receive Bursary Funds. If I am a successful recipient, I will provide my social insurance number to the Devon General Hospital Foundation.
PublicAward

If I am successful in receiving a bursary, I give permission for the Foundation to make public my award.
Parent or guardian full name, if under 18 years of age
Education Information
What year did you graduate from High School?
Grade Average
Expected post secondary school
Program of Study
What year will you graduate from your program of study
List current school activities/sports you are involved in?
What volunteering have you done related to healthcare
What volunteer activities have you been involved in?
Provide examples of how you demonstrated leadership
List part time employment if applicable
Please Attach: (multiple file uploads)
Essay

An essay of approximately 250 words of why you should receive this bursary.
Reference Letter

A current letter of reference from a teacher, professor or education counselor.
Acceptance Letter

A copy of the letter of acceptance into the chosen program of study.
Attach and Upload Files
Filename
Size
Process
Status
Choose File
Max: 4MB - File Type: PDF, DOC, DOCX
Deadline For Submissions is September 30th, Midnight.
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Intro

Bursary Awards Application

Live Forms

Applicants Information

Education Information

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Proudly supporting the Devon General Hospital Since 1984

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