KOREAN CANADIAN SCIENCE SCHOLARSHIP FOUNDATION

Award Application Form

 

 

Student Name (English)

 

 

(Last)                (First)                          (Middle Initial)

Student Name (Korean)

 

Date of Birth (dd/mm/yyyy)

 

School

 

Year/Major

 

Student Number

 

Permanent address

 

Home Telephone

 

Other Telephone

 

E-mail

 

Fax

 

Social Insurance Number

 

Citizenship

Canadian Citizen        Landed  Immigrant          t    

 

Have you ever received an award from other Scholarship Foundation?         (Yes/No)

Please identify the scholarship foundation if you have received.

                                                 

                                                  

 

I have examined this application and certify that all information given is complete and accurate to the best of my knowledge.  I agree to accept the decision of the Foundation as final and I agree that all documents submitted shall be property of the Foundation and shall not be returned.  I consent to the publication of information that I provide for the Foundation’s promotional purposes.  If awarded a scholarship, I am willing to comply with the stated terms.  I understand that the information will be considered confidential for review.

 

 

Signature:                                                                                                                  

                         

 

Date:                                                                                 

 

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