NDHL Bursary Application Form

NIAGARA DISTRICT HOCKEY LEAGUE - BURSARY APPLICATION - 2025
Name

First NameLast Name
Email
example@example.com
Phone Number
Date of Birth

MonthDayYear
Date
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Educational Information
Name of High School Attended
Year Graduated
Latest Grade(s) Percentile
or Date Expected to Graduate

MonthDayYear
Date
Name of College / University / Skilled Trade / Institution you will be attending to WITH expected start date
Are you a member of any organization in your school or receive any scholastic achievements ? Please provide information
Are you a member of any organization outside your school or have volunteer or community involvement experience ? Please provide information
Please provide your current local NDHL Hockey Association of enrollment AND previous amount of years playing hockey in the NDHL or it's included Association(s)

Please provide any further information that might support your bursary application

I CERTIFY THAT ALL STATEMENTS OR INFORMATION I HAVE PROVIDED ABOVE ARE TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE. ANY DELIBERATE MISREPRESENTATION FOUND IN THIS APPLICATION MAY BE CAUSE FOR THE APPROVAL OF THIS APPLICATION AND MAY PROHIBIT ME FROM APPLYING AGAIN IN THE FUTURE.
Applicant's Signature

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Name of Applicant

First NameLast Name
Date Signed by Applicant

MonthDayYear
Date
Should be Empty:

NIAGARA DISTRICT HOCKEY LEAGUE - BURSARY APPLICATION - 2025