Thorncliffe Greenview Scholarship Application

Name: ______________________________________________________

Address: _____________________________________________________

Phone #:          __________________            Date of Birth:  __________________

Father:             ____________________        Mother:           __________________

School Attended Grade 10    __________________________

Grade 11    __________________________

Grade 12    __________________________

Course study you intend to follow:    _______________________________________

At what Secondary Institution:          _______________________________________

References: Name two people other than relatives to whom references can be made for verification of the above information.

Name:                                        __________________________________

Address & Postal Code          _________________________________

Phone #:                                    _______________________

Name:                                         ____________________________________

Address & Postal Code          _________________________________

Phone #:                                     ________________________

Applicants are required to write a short statement setting forth the type of career for which they wish to prepare at a particular post-secondary institution.

Please submit statement on a separate, attached piece of paper.