Joint Application- SMC Catholic Core and the Archbishop’s Scholarship for Leadership in Catholic Education

I am a/an *

Teacher Education Assistant Vice Principal Principal

Years employed with CISVA *

School *

My educational background is (select highest level of education completed) *

High School Diploma Bachelor's Degree Master's Degree Doctorate Degree

I intend to register for Catholic Core Courses *

for credit as an auditing student

I am interested in taking the following Catholic Core courses (choose all that apply): *

SCRI 505 - Introduction to Scripture THEO 501 - Foundations of Theology THEO 530 - Christian Morality

I am interested in completing *

Graduate Certificate (15 credits) Master's Qualification Catholic Core Courses only Not sure

Personal Summary
Please outline why you wish to take these courses, why you think you qualify for this scholarship, how you see this study as assisting you in your teaching work with CISVA and how you will apply these learnings into your day-to-day lesson planning, your motivation for taking these courses. Please also include your leadership experience in Catholic Education. (maximum 600 words)

Upload Personal Summary document here *

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Full Name *

First Name Middle Name Last Name

Gender *

Female Male

Citizenship *

Canadian citizen Permanent Resident

Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country

Phone Number *

Area Code Phone Number

E-mail *

Birth Date *

Month Day Year

Emergency Contact *

First Name Last Name

Relationship *

Emergency Contact Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country

Emergency Contact E-mail *

Emergency Contact Phone *

Area Code Phone Number

The personal information on this form may be collected, used, disclosed for the purposes of admission, registration, research, student association, emergency, alumni development, opportunity to support St. Mark's College/Corpus Christi Colleges, and other purpose and activities with the mandate of the Colleges and related to being a member of the Colleges' community and attending a post-secondary institution in the province of British Columbia.

By registering for the Catholic Core courses (SCRI 505, THEO 501 and THEO 530), and if I am a recipient of an Archbishop's Scholarship, I consent to the use and disclosure of my name, grades, and any reports related to my attendance at St. Mark's College to the Catholic Independent Schools of the Archdiocese of Vancouver (CISVA) of 4885 St. John Paul II Way, Vancouver, BC V5Z OG3.

It is understood that if I receive the Archbishop's Scholarship, I can use it for at least 1 Catholic Core course, and possibly for all 3 courses, provided that I fulfill the requirements of achieving a course grade of 70% or greater and I check with the College to confirm that there are ongoing funds available.

I have read and understood the above statements. *

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Date *

Month Day Year

Signature *

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Updated April 22, 2020

Application for the St. Mark's College Catholic Core Program and the Archbishop’s Scholarship for Leadership in Catholic Education

Program Information

Contact Information

Release of Student Personal Information