BLMG Youth Scholarship Application Form
Please fill out the application form carefully
Student Details & Contact Information
Full Name
First Name
Last Name
Gender Identity
Birth Date
Please select a month
January
February
March
April
May
June
July
August
September
October
November
December
Month
Please select a day
1
2
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31
Day
Please select a year
2026
2025
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
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1926
1925
1924
1923
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1921
1920
Year
Street Address
City
Province
Postal code
E-mail
example@example.com
Phone Number
Format: (000) 000-0000.
I am a student who Identifies as a Black, Indigenous or Person of Color
Yes
No
How do you identify? Select all that apply
Black
Indigenous
Person of Color
Post-secondary Information
What year of study are you entering?
1st year
2nd year
Name of Post secondary Institution
Program/ Field of Study
Application Checklist
Letter of Acceptance (1st year only)
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Confirmation of Enrollment from post -secondary institute (1st & 2nd year students)
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What does Black lives Matter mean to you? (500 words)
*
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for general information or questions about the BLMG Youth Scholarship Award, please contact the BLMG committee by email blmgolf.2020@gmail.com
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