2015 Virgin Lodge #3 Scholarship Application

NOVA SCOTIA FREEMASON’S BURSARY 2015
VIRGIN LODGE NUMBER 3
1. PERSONAL DETAILS OF APPLICANT:
(a) Name (Block Capitals)/ (Underline Surname)___________________________________
(b) Date of birth:____________________________________________________________
(c) Address for correspondence: _______________________________________________
__________________________________________________
(d) Telephone where you may be reached: H __________________C___________________
2. PRESENT STATUS:
(a) Are you planning to attend a post secondary institution in Atlantic Canada or the Nova Scotia
Community College in a Diploma or Certificate Program after graduation this year? YES/NO
(b) Will you be attending as a full time student?
YES / NO
(c) What degree, certificate or diploma do you expect to obtain?
___________________________________________________________________________
(e) Name of University in Atlantic Canada or Community College in Nova Scotia you are
planning to attend?
3. Please provide Virgin Lodge Number 3 with your SOCIAL INSURANCE NUMBER,
which is required for our tax and reporting purposes: _____________________________
4. Please include with this application form:
 A photocopy of all reported marks
 A short essay of 200 words describing the basis of financial need for this bursary;
 a small 3” x 5”colour photo; and,
 Two written recommendations from present or past teachers or members of the
community
Date: _________________
Signature_________________________________
NOTES
Please note that in addition, those students choosing Saint Mary’s University or
Dalhousie University are eligible for a matching $1000.00 President’s Award if they do
well at Christmas, and remain enrolled for the second semester.
The importance of including your Social Insurance Number cannot be overemphasized,
as without it, we cannot by law award these monies to the successful applicant. This has
happened in the past.
Please ensure these forms are forwarded to your guidance Department by the deadline
date that your school sets for you.
The successful candidate will be presented with a letter at their graduation, introducing
them to the School Registrar at their chosen school. The registrars all know to send this
note to the Masonic Foundation, invoicing us for the Scholarship Funds. Should you
misplace this letter, you may obtain another copy by contacting me at the address
below.
I wish all candidates who apply success in their higher academic pursuits.
Sincerely,
John M. Cody
Colonel (Retired)
2 Craigburn Court
Dartmouth, NS B2X 2Y3
John.cody@bellaliant.net