Bursary Application

Required Fields *

This application form is to be completed by the survivor and they must be working with a support agency to qualify.

I have read the Survivors Fund Application Overview from the link below.

Concord Survivors Fund Bursary Overview

STUDENT INFORMATION

*First Name

*Last Name

*Date of Birth

*Daytime Phone Number

*Email AddressUsed to email completed documents

Please double check that your email entered above is correct.

STUDENT ADDRESS

*Address Line 1

Address Line 2

*City

*Province

*Postal Code

PROVINCIAL AND FEDERAL GOVERNMENT STUDENT LOAN PROGRAMS

*Have you applied for a Federal and/or Provincial Student Loan?

Yes

APPLICANTS EDUCATIONAL BACKGROUND

Please provide ALL high schools attended. Fill out the additional fields if you have attended more than one high school.

*Name of High School Attended

*Years Attended

*Diploma Received

Name of High School Attended (if multiple)

Years Attended

Diploma Received

APPLICANTS POST SECONDARY BACKGROUND

Please provide all previous post secondary schools attended. Fill out the additional fields if you have attended more than one post secondary school.

*Have you attended a post secondary education school in the past?

Yes

CURRENT EMPLOYER

Current Employer and Current Occupation(if applicable)

INSTITUTION APPLIED TO

Please provide the information on the educational program you are seeking a Bursary for.

*Name of Institution

*Area of Study or Program Name

*Estimated Cost of Annual Tuition(do not include living expenses or student activity fees)

*Date you expect to receive confirmation of acceptance to the program

*Address of Institution

*Length of Program

*Date of Application to the Program

*Student Number

Please note that proof of acceptance, a schedule of fees to your program of choice, your assigned student number, and name of payee at the institution to whom funds are to be dispersed are required before a bursary will be approved by the Committee.

ADDRESS WHERE BURSARY CHEQUE SHOULD BE MAIL TO

*Attention of

*Address of the Educational Institution

*City

*Province

*Postal Code

*Phone Number

If you do not attend and/or drop classes any refund will be returned to the "Seeds of Hope Foundation".

PERSONAL ESSAY

Each applicant must complete a personal essay answering the following questions.

*Provide a Brief Description of Yourself, Your Preferred Area of Study, and Your Career-related Goals

*Describe where you see yourself in 5 years. Please include the steps you would take to achieve this vision and how your life would be positively impacted if you were a recipient of this bursary. Submit your response on a separate sheet and attach to this application.(Please limit to 500 words in total)

HUMAN TRAFFICKING SUPPORT GROUP OR AGENCY

*Name of Agency

*Address of Agency

*Length of Time Working with the Agency

*Name of Caseworker

*Caseworker’s Phone Number

After selecting the "Create" button the necessary documents will be emailed to you (please check your junk box folder). ALL Documents should be reviewed and where applicable signed. If any signature is missing within the application documents they will not be reviewed by the Bursary committee. Once you have signed the document please forward to your advocate who will need to complete the form on https://www.survivorsfund.ca/advocate-bursary-application/ and forward to us along with their Letter of Support.

Bursary Application

RESTAURANTS

List of participating restaurants will be available February 1st, 2022.

Valentine's Live Event

Get Ready!

The video link will be available Monday February 14th at 5:00 pm local time.