test form NameEmail Address *PhoneStreet AddressApartment, suite, etcCityProvincePostal CodeWe like to publish scholarship recipients’ information in local media and on our website. Please check to boxes below to indicate your consent. I consent to publication of my picture. Consent I consent to publication of my name.Consent I give permission for my school to release my photo to CFUW Orillia.Consent I certify that I have not used any paid professional services to complete this application.Which school are you or will you be graduating from? *Orillia Secondary SchoolPatrick Fogarty Catholic Secondary SchoolTwin Lakes Secondary SchoolSimcoe Shores Secondary School – Orillia CampusESC-Nouvelle-AllianceEcole Secondaire Romeo-DallaireStudents studying at the Orillia Learning CentreMature Students planning to enter a college or university in the fall.What is your overall average for credits on your transcript for grades 11 & 12?Calculation Instructions: Total all marks for these grades and divide by the number of credits. For half credits divide the final mark in two before adding it in.1. Why did you choose not to pursue post-secondary education immediately after high school?2. What skills and knowledge have you gained from work/life experiences that will help you as you further your education?1. Why did you choose to attend The Learning Centres?2. What knowledge have you gained from life experiences prior to entering The Learning Centres, and how has this helped you in your classes?3. Are there courses taken and not listed on your transcript that you would like to include? (i.e., First Aid, computer, Early Childhood Education)InvolvementDetail your involvement at school, in the community, at work, and in your personal life, describing ways that you demonstrate the characteristics which qualify you for a CFUW Orillia scholarship. Be sure to draw on your experiences over the years (such as throughout high school). If you have little to no involvement, you are welcome to share that in the space provided below..At School(i.e., student council, committees, team sports, band, choir, drama, chess or any school-based group).Personal ActivitiesPersonal ActivitiesPersonal ActivitiesIn your communityPlease describe your volunteer activities or responsibilities in the community. Include involvement in community groups, political groups, the arts, religious activities, and paid employment. Be sure to indicate beside each activity as to whether it is paid or volunteer. When describing a co-op placement, please also write “Co-op” in the ‘Your Role’ box.With Family and FriendsThis can include ways you support your family in their activities, advocate for them in their community, or coordinate a social circle of friends.If you have little to no involvement, please share why if you are comfortable.Please know that this information will remain confidential unless you provide your explicit consent to share.Personal BackgroundCompose a paragraph of at least 200 words explaining how you meet the required criteria for a scholarship (refer to page 1) and how receiving a CFUW scholarship would help with your postsecondary goals.Career Goals1. What are your future career goals? *2. Which post-secondary program and/or institution have you applied to or have been accepted to as a student for the fall?3. What course/major have you applied to?4. Optional QuestionIs there any other information you would like to share with us that you think would help us in evaluating your application? For example, describe a moment in your life that made you feel particularly proud of yourself.Upload fileChoose FileNo file chosenDelete uploaded fileAcademic Letter of ReferenceUpload fileChoose FileNo file chosenDelete uploaded filePersonal Letter of ReferenceUpload fileChoose FileNo file chosenDelete uploaded fileHigh School TranscriptSubmitSave as Draft
