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PERSONAL DATA:
Name:_____________________________________________________________
Surname
First Name
Initial
Address:___________________________________________________________
City: _____________________ Province: ____________Postal Code:
__________
Telephone: (__) ______________ Email Address___________________________
Date of Birth: ______________________________
month day
year
Relationship to Sponsoring ARTA Member: ________________________________
Applicant’s Signature: ________________________________________________
ARTA SPONSORING MEMBER’S DATA:
______________________________________________________
Surname
Given Names
ARTA Sponsoring Member’s Number: ______________ Expiry Date: ________
ARTA Sponsoring Member’s Signature: ________________________________
VALIDATION SIGNATURES:
By signing this application, you both agree that all the information you
have disclosed or
provided is accurate and complete to the best of your
knowledge at the time of signing.
EDUCATIONAL DATA:
HIGH SCHOOL
Name of High School __________________________
Year High School Completed: ___________________
POST SECONDARY INSTITUTION
Name of institution where you have successfully completed at least one
year
of a program: _______________________________________________________
Name of the Program: ____________________ Length of Program (yrs):
_______
Year of expected program completion: _____________
[If you are transferring, provide the following information]
Name the Institution where you are enrolling:
__________________________________________________________________
Address: ___________________________________________________________
City: ___________________ Province: ______________ Postal Code:
__________
Beginning year: ________Year of expected program completion:
______________
____________________________________________________________________________
Please attach to this application a summary of the following:
- CAREER PATH:
Explain your career goals.
- COMMUNITY
INVOLVEMENT AND VOLUNTEER WORK
- PERSONAL
ACCOMPLISHMENTS
- ACADEMIC
MARKS: Please enclose:
-
An official transcript or
authenticated copy of your high school marks
-
An official transcript or
authenticated copy of the first, second or third- year marks of
the post-secondary institution. (For example if you are entering
the second year
of a program, please provide the marks attained
in the previous year)
5. LETTERS OF REFERENCE:
TWO letters of reference must
be included with the application and mailed directly to the Executive
Secretary of ARTA by the application deadline of July 31. The chosen
references should not be directly related to you but should be
knowledgeable of your accomplishments, capabilities and character. You
are encouraged to use the letters of reference form provided with this
application package. Please remember to provide the complete addresses
and phone numbers of your selected references should we not receive
their letters by the adjudication date and need to contact them.
REFERENCES MUST BE
RECEIVED BY JULY 31st.
Please send the reference to:
The
Executive Secretary, ARTA
409 Barnett
House
11010 142
St. NW
Edmonton, AB
T5N 2R1
_______________________________________________________________
ARTA-JOHNSON SCHOLARSHIP REFERENCE
LETTER OF REFERENCE
Name: _________________________________________________________
Address: _______________________________________________________
City: ___________________Province: _____________ Postal Code: ________
Phone number: Home: ( ) _______________ Work: ( ) _______________
Applicant’s Name: ________________________________________________
1. How long have you known the applicant and in what capacity?
____________________________________________
2. Describe the applicant’s character.
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________
3. Describe the applicant’s qualities as they relate to leadership,
communication skills, community involvement, volunteerism and other
achievements.
_______________________________________________________________
_______________________________________________________________
4. Describe any other factors that should be considered by the Selection
Committee.
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________
Signature: ________________________________________
Date of completion of reference letter: __________________
REFERENCE MUST BE RECEIVED BY JULY 31st.
Please send the reference to:
The Executive Secretary, ARTA
409 Barnett House
11010 142 St. NW
Edmonton, AB T5N 2R1
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