Jack Davis Scholarship Application
Deadline for submission is April 30th
Check Boxes to Acknowledge Scholarship Requirements
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I am a Canadian Citizen and have lived in Canada for at least 5 years
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I am a resident of North or West Vancouver and have attended secondary school there for the past 3 years
Name
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Full Name
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First Name
Middle Name
Last Name
Email
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Facebook Profile URL
optional
LinkedIn Profile URL
optional
Date of Birth
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Month
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Day
Year
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Address
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Street Address
Street Address Line 2
City
Province
Postal Code
Phone Number
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Area Code
Phone Number
Name of Secondary School you will Graduate Grade 12 at
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I refer the Committee to the following persons, under at least three of whom I have studied at High School, and from whom confidential information may be obtained concerning my qualifications:
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List of my principal activities and honours while in Secondary School (including prizes, awards, offices held, athletic record and extracurricular interests and activities) with dates
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Secondary School Training (schools attended, dates, honours, etc.)
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Statement of my general interests and activities, my proposed course of study at UBC, and my present intentions as to my future career
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not to exceed 500 words
0/500
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Photograph of head and shoulders
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Birth Certificate
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Written Statement from the Principal of my Secondary School to the effect that I am approved as a suitable candidate for The Jack Davis Scholarship
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Certification by the Registrar or other responsible official of my High School of the courses of study I have taken together with my grades and academic achievements
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List of my principal activities and honours while in Secondary School (including prizes, awards, offices held, athletic record and extracurricular interests and activities) with dates
*
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of
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