This scholarship program is open to students within the Metro Vancouver region who have completed grade 12 or are in the final year of high school or are currently enrolled in a BC college, institution or university.

In addition to filling out the form below, the applicant must submit a 250 to 400 word essay, describing the environmental leadership involvement on which this application is based. Briefly outline what motivated you to undertake this activity, what you feel was accomplished, and what you learned from the experience.

A second essay, 100 to 150 words in length, describing your personal, family or other extenuating circumstances that may be relevant to your application, is optional. You can upload both essays as Word or text documents at the bottom of the form below.

No other material will be presented to the members of the Selection Committee. Materials cannot be returned.

All Applicants will be notified by email confirming receipt of their application and by letter October 19th, 2012 as to the status of their application.

Applications must be submitted no later than October 5, 2012.

first name

middle name

last name

Mr./Ms.

address

apt

telephone

city

province

postal code

graduation date

school currently attending

school address

city

province

postal code

telephone

Summarize in 250 to 400 words the nature of your environmental leadership involvement on which this application is based. The document should be a text document, a Word document or a pdf, text only with no pictures. Please include your name as part of the file name and upload the document below.

name

position

telephone

email

email

List up to three careers or occupations you are considering, in order of preference. If you don’t know yet, indicate “not determined”.

To be completed by grade 12 student applicants only:

name of educational institution you plan to attend

anticipated start date

Do the activities described in your application exceed the community service hours required to graduate?

To be completed by all applicants:

Anticipated or current course of study and degree/diploma sought.

List extracurricular activities in which you have participated and specify the nature of your involvement and leadership role in each.

activity

role

year(s)

List your hobbies or special interests that you are involved in.

List your summer or part-time jobs you have held, if any, specifying employer, type of work and length of time in position. Indicate (S) for summer job and (Y) for work completed while attending school.

employer

type of work

month(s)/year(s)

Summarize in 100 to 150 words your personal, family or other extenuating circumstances. The document should be a text document, a Word document or a pdf, text only with no pictures. Please include your name as part of the file name and upload the document below.

grade point average previous school year

List two references to support your application