Brenda Fawkes Student Bursary Fund

Brenda Fawkes Student Bursary Fund

Application Form: Submission deadline - January 15 and June 15
Section A - Applicant Information
Legal Name

First NameLast Name
Preferred Name (if different)
Preferred Pronouns
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Date of Birth

MonthDayYear
Date
Social Insurance Number (SIN)
Section B - Candidacy Status
Are you a recognized Candidate for Ministry in The United Church of Canada (i.e. Have you been assessed for suitability for ministry by a Candidacy Board?)
If not, have you been assessed for promise for ministry by a Candidacy Board?
Which Candidacy Board are you connected to?
Data of most recent assessment by Candidacy Board.

MonthDayYear
Date
Region of (intended) Candidacy
Section C - Educational Program
Name of Educational Institution or Program
Program Title (If applicable)
Degree/Diploma/Certificate sought
Start Date

MonthDayYear
Date
Expected Completion Date

MonthDayYear
Date
Is this a United Church related program?
Are you currently enrolled ?
Section D - Financial Information
Estimated Total Cost of Program (tuition, books, fees) for this academic year
Estimated Living Expenses (per year)
Total Financial Need for this academic year
Other Sources of Financial Support (employment, family, other bursaries)
Amount requested from Brenda Fawkes Student Bursary Fund
Please attach a brief budget outlining your income and expenses and any supporting documentation (e.g. tuition invoice, proof of enrolment)

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Section E - Personal Statement
Please attach a 1 to 2 page statement that includes: Your vocational journey and call to Ministry. How this bursary will support your formation and studies. Your vocation goals. Any relevant community involvement or leadership experience. Any additional context regarding financial need.

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Section F - Reference

Please provide the name and contact information for one reference (e.g., Vocational Minister, Candidacy Board member, congregational minister, faculty member, other):
Name

First NameLast Name
Role/Relationship
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Section G - Declaration

I declare that the information provided in this application is true and complete to the best of my knowledge. I understand that the information will be used to assess my eligibility for the Brenda Fawkes Student Bursary Fund.
Signature
Date

MonthDayYear
Date
Should be Empty: