YFU USA Mazda Canada Scholarship Application

  • Mazda Canada Scholarship Application

  • General Information

    • Student Information 
    • Date of Birth*
       / /
    • Sex*
    •  -
    • Do you have dual citizenship?*

    • Mazda Employment Information

    • Emergency Contact

    •  -
    • Family Information 

    • Parent/Guardian 1

    • Address is same as student's*
    •  -

    • Parent/Guardian 2

    • Address is same as student's
    •  -

    • Siblings

    • Accommodations 
    • Can you live in a household with both cats and dogs?*
    • Do you have any health conditions or allergies that could affect your placement?*
    • Are you OK with living in a household in which members smoke?*
    • Have you had mental health counseling/therapy in the past two (2) years?*
    • Do you have any medical or religious dietary restrictions?*
    • Will you require regular attendance of religious services while abroad?*
    • Are you open to attending a religious service with your host family for the cultural experience?*

  • Interests and Motivation

    Tell us a bit about yourself, your interests, and why you would like to study abroad.

  • Do you have a direct placement request? If yes staff will reach out to confirm your requested host family's contact information.*

  • Essay Questions

     

  • Sign and Submit

  • Should be Empty: