Yes2Me Scholarship Application Form

Yes2Me Scholarship Application Form
Please ensure you have all of the necessary documentation ready before submitting:
- Proof of residency (e.g., government-issued ID or utility invoice)
- Reference form
- A letter describing career and study goals, and why the applicant selected the Eligible Program.
- Completed application form (this form)
Legal Name
Date of Birth

MonthDayYear
Date
Address

Home Address

Street Address Line 2

CityProvince

Postal Code
Phone Number
Email Address
example@example.com
Diagnosis
Current highest level of education (Please check the most applicable):

Some high schoolCompleted high schoolTrade or vocational schoolCollege certificate or diplomaUndergraduate degreeGraduate degree
Name of chosen accredited institution for the Eligible Program
Desired program or area of study

Estimated Tuition

	Tuition	Books	Other
Estimated Total

A completed reference form must accompany this application. Please upload below:

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Please upload a proof of residency (e.g., government-issued ID or utility invoice)

Cancelof
Please upload a letter describing your career and study goals, and why you have selected the Eligible Program.

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Applicant Signature

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Submission Date

MonthDayYear
Date
Yes2Me Scholarships are sponsored by the Otsuka-Lundbeck Alliance and the BC Schizophrenia Society
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