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Canada's Private Sector Union

Please complete all sections carefully. Incomplete or inaccurate application forms are subject to disqualification.

To qualify for the UFCW Canada - BDM Scholarship program you must be a UFCW Canada member in good standing or a dependant/spouse of a UFCW Canada member in good standing.

The student must also be enrolled (or will be enrolled on September 30) and attending full-time studies at an accredited Canadian college or university.

APPLICANT (STUDENT) INFORMATION:

Is applicant (student) a member of UFCW Canada? *

YesNo

The applicant (student) is a: *

UFCW Canada Local: *

Employed at: *

(workplace/location)

First Name: *

Last Name: *

Permanent Address: *

City: *

Province: *

Postal Code: *

Phone: *

Cell:

Email: *

Enrolled at (Canadian post-secondary institution): *

Name of program: *

Year of my program: *

MEMBER INFORMATION:

Member of UFCW Canada Local: *

Member's First Name: *

Member's Last Name: *

Member is employed at: *

(workplace/location)

I hereby confirm that all information submitted herewith is true and complete, and that I have never been a recipient of this scholarship in the past.

DEADLINE FOR APPLICATIONS: SEPTEMBER 30

Verification

Canada's Private Sector Union

UFCW Canada - BDM Scholarships: Official Application

APPLICANT (STUDENT) INFORMATION:

MEMBER INFORMATION:

DEADLINE FOR APPLICATIONS: SEPTEMBER 30