Surrey Teachers’ Association Awards Application (Open to children of STA Members)

Name

First

Last

Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Phone

Email

Name of Parent or Guardian (who is an active member of the Surrey Teachers’ Association)

First

Last

Their Work Site

Applicants may wish to provide, on a voluntary basis, information as to whether they self-identify as a member of one or more equity-seeking groups. This includes women, racialized persons, Aboriginal persons, persons who are trans, gender diverse or two-spirit, persons with a disability, and persons who are lesbian, gay or bisexual.

Yes
No

I self-identify as

Awards for which I’d like to be considered

Please check all that apply

Scholarship (6 x $2000 will be awarded in the Fall)
Bursary (6 x $2000 will be awarded in the Fall)
Wadge Memorial Social Justice Award (2 x $2000 will be awarded in the Fall)

Education Secondary

Secondary School (from which you graduated)

Secondary School Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Phone

Layout

Please submit Official Transcript of final grade 12 marks.

Click or drag a file to this area to upload.

Academic Goals

Proposed Program of Study

Length

Eventual Career Goals

Layout (copy)

Include proof of enrollment in a post-secondary institution in the form of a confirmation of Acceptance to an approved program, a List of Enrolled Classes or proof of payment of tuition, all on Institutional Letterhead. (Registration fee receipt must be presented prior to an award being paid as per Policy 2.N.02.d.)

Click or drag a file to this area to upload.

Agreement

I have read all instructions, and included all the required documents with my completed application form. I certify that all statements on this application are true and complete.

Signature

Clear Signature

Date

Surrey Teachers’ Association Awards Application (Open to children of STA Members)

Awards for which I’d like to be considered

Education Secondary

Academic Goals

Agreement

SCHOOL AND COMMUNITY INVOLVEMENT IN A VARIETY OF AREAS

A: School Involvement in a Variety of Areas (attach additional page if necessary)

B: Community Involvement in a Variety of Areas

C: Candidate’s Statement of Goals

D: Candidate’s Statement of Financial Need

E: Candidate’s Statement of Commitment to Social Justice

F: Academic Achievement Reference

G: School-based Extracurricular Involvement Reference (copy)

H: Community Involvement Reference

Reference Submissions