JELMS Application 17-24 yrs old
NOTE: ALL INFORMATION SHARED ON THIS APPLICATION IS AND WILL REMAIN CONFIDENTIAL. I would like to be considered for the Jose Eduardo Lopez Memorial Scholarship being offered by the Board of Directors. By completing this application, I authorize the committee to collect information, documents and references in order to evaluate my application.
Name
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First Name
Last Name
Email Address
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Primary Contact Number
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Area Code
Phone Number
Address
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Required: Provide proof of address
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PLEASE REVIEW CHECKLIST FOR REQUIREMENT DETAILS
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Required: document to confirm you are between 17-24 years of age
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PLEASE REVIEW CHECKLIST FOR REQUIREMENT DETAILS
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Document of immigration status in Canada (Birth certificate, Canadian citizenship, permanent resident card, notice of decision from the Immigration and Refugee Board or letter of approval from the Canadian government)
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Name of post secondary institution you are enrolled in
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Official document confirming your registration or student number
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LETTER OF ENROLLMENT
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Name of program or career you have chosen
Transcript (required as proof of GPA of 80% or higher)
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Outline your living expenses?
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What is the annual tuition fee?
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What is the projected cost of books?
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What was your income last year? (required if applicable to you)
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INCLUDE PERSONAL NOTICE OF ASSESSMENT
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Are you currently employed?
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Yes
No
If your answer to the previous question is "Yes", this field is required.
NAME OF EMPLOYER
How much of your own financial resources are you contributing towards your school fees (budget and personal savings)
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Do you receive or will you be receiving financial support from any of the following (check all that apply)
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Parents
Guardians
Spouse
Family
Friends
If you are receiving financial support as mentioned in the previous question, It is required for you to enter a copy of that source's personal income tax assessment
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Have you applied for other scholarships or bursaries?
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Yes
No
If your answer to the previous question is "yes", specify value of other scholarships or bursaries
REQUIRED : IF YOU ANSWERED YES TO PREVIOUS QUESTION
Have you applied for or received OSAP?
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Yes
No
If your answer to the previous question is "yes", provide document outlining value of OSAP loan received
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REQUIRED : IF YOU ANSWERED YES TO PREVIOUS QUESTION
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Required: Provide a letter of reference from a place where you have done volunteer or community work
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COMMUNITY OR VOLUNTEER WORK
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Required: Provide a personal letter of reference (must not be from a family member
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PERSONAL LETTER OF REFERENCE
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Upload of your resume here
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1000 word essay: Please ensure you follow guidelines and answer 5 questions outlined below: 1. Why are you applying for this scholarship? 2. Which career would you like to complete? Please be specific in terms of your aspirations. 3. How will this scholarship help you meet your school goals and career aspirations? 4. How has your Hispanic heritage shaped your values, beliefs, and goals and how do they relate to the ideals of Jose Eduardo Lopez? 5. How has you volunteer work impacted your life and your community?
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Make sure you review this checklist to ensure all required documentation has been submitted for review and consideration of your application. If all required documents are not submitted it may result in your application being disqualified:
Letter of employment (if applicable)
Proof of date of birth (17-24)
Document that shows you GPA of 80% or higher (transcript)
Letter of acceptance from college or university, receipt of tuition or a letter that demonstrates you are a fully registered student at the time of application
Proof of address (to be considered, candidates must reside in the Hamilton area, Grimsby, Ancaster, Dundas, Flamborough, Hamilton, Stoney Creek, Waterdown, Binbrook, Hannon and Mount Hope)
Two letters of reference (one personal not from a family member and the other from a place you have completed volunteer or community work)
Demonstrate financial limitations (personal tax assessment or parents/relatives tax assessment, OSAP documents)
Write essay of 1000 words in English or Spanish answering 5 key questions required
Document proving your legal status in Canada (Canadian citizenship, permanent resident card, or letter of approval from the Canadian government)
Documentation and Declaration Section: I declare that to the best of my knowledge, all the information I have given in this application is true and accurate.
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Clear
THE JELMS Jose Eduardo Lopez Memorial Scholarship RELEASE FORM: Waiver to use likeness: I hereby grant JELMS permission to use my likeness in a photograph, video, or other digital media (“photo”) in any and all of its publications, including web-based publications, magazines, etc., without payment or other consideration. I understand and agree that all photos will become the property of the JELMS and will not be returned. I HAVE READ AND UNDERSTAND THE ABOVE PHOTO RELEASE. I AFFIRM THAT I AM AT LEAST 18 YEARS OF AGE, OR, IF I AM UNDER 18 YEARS OF AGE, I HAVE OBTAINED THE REQUIRED CONSENT OF MY PARENTS/GUARDIANS AS EVIDENCED BY SIGNING THIS SECTION I GIVE MY CONSENT
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Clear
Do you agree with above waiver
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Yes
No
Date:
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Month
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Day
Year
DATE OF SUBMISSION
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