2014 Fall Application for Undergraduate Awards 2014 application.pdf · Brady Salloum Memorial...

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2014 Fall Application for Undergraduate Awards Student Awards & Financial Aid Enrolment Services Signature Date (DD/MMM/YYYY) 2014 Fall Application for Undergraduate Awards Student Awards & Financial Aid Enrolment Services Administration Humanities Building 108 University of Regina Regina, SK S4S 0A2 Fax: 306.585.5559 Inquiries: 306.585.5556, [email protected] INSTRUCTIONS Students are encouraged to register online on SAMS (Student Awards Management System) to apply for awards. http://www.uregina.ca/safa/awards/SAMS/index.html Submit only one copy of this application form (online or paper). Incomplete applications will not be considered. Select only the awards for which you meet the selection criteria and wish to be considered. Criteria for all awards can be found online on SAMS. Enclose additional materials such as letters of reference or essays only if required as outlined in the award description. Please write the name of the award on these materials, along with your name. Faxed and scanned applications will be accepted, but any letters of reference must be sent directly to the University of Regina (by email, fax or hard copy) from the referee, and must clearly include the student name and the name of the award. GENERAL INFORMATION Last Name First Name UR Student ID Number Date of Birth (DD/MMM/YYYY) Are you registered with the University of Regina Centre for Student Accessibility as a student with a permanent disability? Yes No Social Insurance Number: ________________________ Aboriginal declaration: Status Indian Métis Non-Status Indian Inuit Declaration & Consent I declare that the information I have provided in this application is true, complete and accurate. I understand that all information I have provided in connection with this application is subject to verification and audit by the University of Regina. I will provide supporting documentation to the University of Regina to verify my eligibility upon request. I understand that any funds I receive will be applied to my student account at the University of Regina. I consent to the disclosure by the University of Regina of my personal information I have given on this application as follows: To other educational institutions, federal and provincial student loan offices to verify its completeness and accuracy. Should I be selected to receive an award, to the donor of the award, University of Regina External Relations and my academic faculty/college the following information: my name, award, program of study, year level and the amount of my award. To opt out, please send a written reque st to Student Awards and Financial Aid Office, Room 108 Administration-Humanities Building, University of Regina, Regina, SK, S4S 0A2; and should I be selected to receive a scholarship, my name, program of study, year level and photograph may be used for promotional purposes. PRIVACY: The University of Regina collects and creates information about students (personal information) under the authority of The University of Regina Act and in accordance with The Local Authority Freedom of Information and Protection of Privacy Act and the Personal Information Protection and Electronic Documents Act, for purposes of admission, registration, and other decisions on students’ academic status, and the administration of the University and its programs and services. Some o f this information may be disclosed to the relevant students’ society and alumni association, and will be reported as required by federal or provincial authority. Information r egarding the admission of current high school students may be shared with the student’s current high school as needed. Any misrepresentation may be shared with other post -secondary institutions. By enrolling in courses at the University of Regina, students consent to the collection, use, and disclosure of personal information as described above. Once an award has been granted, the University of Regina may disclose certain information to the donor of the award, Universi ty of Regina External Relations, provincial funding organizations and/or University of Regina academic departments/Faculties and Colleges as set out in the Declaration and Consent section. If you are the recipient of a scholarship, your name and photograph may be used for promotional purposes as set out in the Declaration and Consent section. If you have any questions about the collection, use and disclosure of your personal information by the University of Regina, please contact: Manager, Student Awards and Financial Aid Office, Room 108 Administration-Humanities Building, University of Regina, Regina, SK, S4S 0A2, 306.585.5345 Realize. Your future. Are you currently working towards the completion of two separate degrees? Please list both degrees: 1. ________________________________________________ 2. _____________________________________________________

Transcript of 2014 Fall Application for Undergraduate Awards 2014 application.pdf · Brady Salloum Memorial...

Page 1: 2014 Fall Application for Undergraduate Awards 2014 application.pdf · Brady Salloum Memorial Scholarship Application must include a copy of correspondence from the Ministry of Advanced

2014 Fall Application for Undergraduate Awards

Student Awards & Financial Aid

Enrolment Services

Signature Date (DD/MMM/YYYY)

2014 Fall Application for Undergraduate

Awards

Student Awards & Financial Aid Enrolment Services

Administration Humanities Building 108 University of Regina Regina, SK S4S 0A2 Fax: 306.585.5559

Inquiries: 306.585.5556, [email protected] INSTRUCTIONS

Students are encouraged to register online on SAMS (Student Awards Management System) to apply for awards. http://www.uregina.ca/safa/awards/SAMS/index.html

Submit only one copy of this application form (online or paper). Incomplete applications will not be considered.

Select only the awards for which you meet the selection criteria and wish to be considered.

Criteria for all awards can be found online on SAMS.

Enclose additional materials such as letters of reference or essays only if required as outlined in the award description. Please write the name of the award on these materials, along with your name.

Faxed and scanned applications will be accepted, but any letters of reference must be sent directly to the University of Regina (by email, fax

or hard copy) from the referee, and must clearly include the student name and the name of the award.

GENERAL INFORMATION

Last Name First Name UR Student ID Number Date of Birth (DD/MMM/YYYY)

Are you registered with the University of Regina Centre for Student Accessibility as a student with a permanent disability? Yes No

Social Insurance Number: ________________________

Aboriginal declaration: Status Indian Métis Non-Status Indian Inuit

Declaration & Consent I declare that the information I have provided in this application is true, complete and accurate.

I understand that all information I have provided in connection with this application is subject to verification and audit by the University of Regina. I will provide supporting documentation to the University of Regina to verify my eligibility upon request. I understand that any funds I receive will be applied to my student account at the University of Regina.

I consent to the disclosure by the University of Regina of my personal information I have given on this application as follow s: To other educational institutions, federal and provincial student loan offices to verify its completeness and accuracy. Should I be selected to receive an award, to the donor of the award, University of Regina External Relations and my academic faculty/college the following

information: my name, award, program of study, year level and the amount of my award. To opt out, please send a written reque st to Student Awards and Financial Aid Office, Room 108 Administration-Humanities Building, University of Regina, Regina, SK, S4S 0A2; and should I be selected to receive a

scholarship, my name, program of study, year level and photograph may be used for promotional purposes.

PRIVACY:

The University of Regina collects and creates information about students (personal information) under the authority of The University of Regina Act and in accordance with The Local

Authority Freedom of Information and Protection of Privacy Act and the Personal Information Protection and Electronic Documen ts Act, for purposes of admission, registration, and

other decisions on students’ academic status, and the administration of the University and its programs and services. Some of this information may be disclosed to the relevant

students’ society and alumni association, and will be reported as required by federal or provincial authority. Information r egarding the admission of current high school students may

be shared with the student’s current high school as needed. Any misrepresentation may be shared with other post-secondary institutions. By enrolling in courses at the University of

Regina, students consent to the collection, use, and disclosure of personal information as described above.

Once an award has been granted, the University of Regina may disclose certain information to the donor of the award, Universi ty of Regina External Relations, provincial funding

organizations and/or University of Regina academic departments/Faculties and Colleges as set out in the Declaration and Consent section.

If you are the recipient of a scholarship, your name and photograph may be used for promotional purposes as set out in the Declaration and Consent section.

If you have any questions about the collection, use and disclosure of your personal information by the University of Regina, please contact: Manager, Student Awards and Financial Aid

Office, Room 108 Administration-Humanities Building, University of Regina, Regina, SK, S4S 0A2, 306.585.5345

Realize. Your future.

Are you currently working towards the completion of two separate degrees? Please list both degrees: 1. ________________________________________________ 2. _____________________________________________________

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2 2014 Fall Application for Undergraduate Awards

Student Awards & Financial Aid

Enrolment Services

Selection of Undergraduate Awards UR Student ID Number

Please indicate with a checked box the awards for which you meet the criteria and wish to be considered. Ensure that you provide any

additional information that may be required in the application package as outlined in the description for the award.

Full descriptions and values for all scholarships, awards and bursaries can be found on SAMS.

Convocation Awards (For students convocating in the Fall 2014 semester) Complete these sections

Chartered Accountants of Saskatchewan Bursary in Memory of J.C. MacKinnon

I intend to seek admission into the CA School of Business. I have accepted an offer of employment from an approved training office in Saskatchewan.

1

Chartered Accountants of Saskatchewan Scholarship

I intend to seek admission into the CA School of Business. I have accepted an offer of employment from an approved training office in Saskatchewan.

University of Regina Celebration Award 2

Entrance Awards (For students in 1st semester of study only) Complete these sections

35 Lions Club of Regina Scholarship 2

Aboriginal Kinesiology and Health Studies Award 2, 3

Association of Professional Engineers & Geoscientists of Saskatchewan (APEGS) Entrance Bursary 1

Bourse d'admission au Baccalauréat en Éducation Française Please see French

application on the SAFA

website.

Cameco Athabasca Basin Student Travel Bursary Applicant must complete the “Cameco Travel Information Sheet” located at www.uregina.ca/safa/forms/index.html.

Charlebois Community School Entrance Award

I am applying to the University of Regina directly from Charlebois Community School in Cumberland House, SK.

Application must include letter of recommendation from the high school principal.

CIC Aboriginal Bursary (for payment in the 2015 Winter semester)

Resident of Saskatchewan since: Month: _____________ Year: ___________

2, 3, 4

Dr. Jack Boan Student Refugee Award I entered Canada under the auspices of the United Nations High Commission for Refugees (UNHCR).

I have just completed a year of sponsorship as a World University Service of Canada (WUSC) Student Refugee Program (SRP) stud ent.

I am a refugee student who came directly to the University of Regina through World University Service of Canada (WUSC).

I am still receiving tuition support from WUSC.

Fine Arts Entrance Award in Theatre

Application must include an essay (2 pages) on the topic “Theatre is Important Because”.

Garth Edward Usick Memorial Bursary 1

Honouring our Future Entrance Bursary I am a member of one of the 74 Saskatchewan First Nations. Name:___________________________________________________________________________________________

1

J.A. Toupin Memorial Scholarship

I am an employee, former employee, or immediate family member of an employee of Viterra (formerly Saskatchewan Wheat Pool).

Resident of Saskatchewan since: Month: _________________ Year: _____________

2, 3

John M. Forbes Bursary 1

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3 2014 Fall Application for Undergraduate Awards

Student Awards & Financial Aid

Enrolment Services

Selection of Undergraduate Awards UR Student ID Number

Please indicate with a checked box the awards for which you meet the criteria and wish to be considered. Ensure that you provide any

additional information that may be required in the application package as outlined in the description for the award.

Full descriptions and values for all scholarships, awards and bursaries can be found on SAMS.

Entrance Awards (For students in 1st semester of study only) continued... Complete these sections

Larry Day Scholarship in Media Production and Studies

Application must include a 500-word statement explaining why the student is deserving of the scholarship and/or describing their vision for their future career.

2

Minahik Waskahigan High School Entrance Award

I am applying to the University of Regina directly from Minahik Waskahigan High School in Pinehouse, SK.

Application must include a letter of recommendation from the high school principal.

Morley Wood Memorial Scholarship for Aboriginal Female Students Application must include a 250-word or less statement of contributions to date with respect to promoting Aboriginal women in com munity-based or regional Aboriginal projects or programs.

1, 3

NASSM Scholarship in Recreation and Sport Management Application must include your resumé.

2, 3

Pat Moir Award

Paul and Carol Hill Scholarship in Business Ethics 2, 3

Project Hero Applicants will be required to provide documentation as indicated on SAMS for this award.

Timmons Mason Endowment 1

University of Regina Aboriginal Athletic Award 2, 3

University of Regina Aboriginal Entrance Award 1

University of Regina Family Scholarship

Students who apply and meet the scholarship’s minimum eligibility requirements can receive the full value of this scholarship as a benefit under each eligible

parent’s plan.

Employee member name:____________________________________________________ _______________ Employee’s number: _________________________________________

Relationship to employee: ____________________________________________________

Employee member name:____________________________________________________ _______________ Employee’s number: _________________________________________

Relationship to employee: ____________________________________________________

University of Regina German Language Entrance Scholarship I am a non-native speaker of German.

Willa Haughton Athletic Award 2, 3

General Awards for Continuing Undergraduate Students Complete these sections

35 Lions Club of Regina Scholarship 2

Association of Chinese Canadian Professors Scholarship

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4 2014 Fall Application for Undergraduate Awards

Student Awards & Financial Aid

Enrolment Services

Selection of Undergraduate Awards (continued) UR Student ID Number

Please indicate with a checked box the awards for which you meet the criteria and wish to be considered. Ensure that you provide any

additional information that may be required in the application package as outlined in the description for the award.

Full descriptions and values for all scholarships, awards and bursaries can be found on SAMS.

General Awards for Continuing Undergraduate Students continued... Complete these sections

Association of Regina REALTORS Ltd. Scholarship I am a dependent of a member of the Association of Regina Realtors.

I am pursuing a first degree.

2, 3

Beta Sigma Phi– Regina City Council Scholarship I am a dependent of a member of Regina Beta Sigma Phi.

Brady Salloum Memorial Scholarship Application must include a copy of correspondence from the Ministry of Advanced Education with the breakdown of unmet need as calculated on application for

Canada-Saskatchewan student loans.

I am pursuing a first degree.

1, 2, 3

C.D. Howe Mature Student Achievement Awards for Excellence

Cameco Athabasca Basin Student Travel Bursary Applicant must complete the “Cameco Travel Information Sheet” located at www.uregina.ca/safa/forms/index.html

Canadian Federation of University Women– Regina Scholarship 2, 3

Canadian Public Relations Society– Regina Chapter Scholarship

Charles Bruce McPherson First Nations University of Canada Bursary

I am residing in Saskatchewan

1, 2, 3

CIC Aboriginal Bursary (for payment in the 2015 Winter semester)

Resident of Saskatchewan since: Month: _____________ Year: ___________

2, 3, 4

Dr. Bill Clarke Rams Defensive Lineman Scholarship Application must include 2 reference letters outlining student’s sport leadership and community involvement.

2, 3

Dr. Bill Clarke University Scholarship 1, 2, 3

Dr. Brian H. Campbell Award in Distance Learning Please provide a separate page with the following information for the 3 courses you completed at a distance: course title, co urse # and section, method of delivery.

Dr. Douglas and Patricia Vandenberghe Scholarship

Dr. Edward Wolstein Award for Students of Aboriginal Ancestry I am a single custodial parent. Number of dependents: ________

1

Dr. Jack Boan Student Refugee Award I entered Canada under the auspices of the United Nations High Commission for Refugees (UNHCR).

I have just completed a year of sponsorship as a World University Service of Canada (WUSC) Student Refugee Program (SRP) stud ent.

I am a refugee student who came directly to the University of Regina through World University Service of Canada (WUSC).

I am still receiving tuition support from WUSC.

Elie and Rose Zalusky Ukranian Language Scholarship 2, 3

Elizabeth and Grant Holden Bursary I am a single custodial parent. Number of dependents: _______

1

Elmer Shaw Part-Time Bursaries 1

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5 2014 Fall Application for Undergraduate Awards

Student Awards & Financial Aid

Enrolment Services

Selection of Undergraduate Awards (continued) UR Student ID Number

Please indicate with a checked box the awards for which you meet the criteria and wish to be considered. Ensure that you provide any

additional information that may be required in the application package as outlined in the description for the award.

Full descriptions and values for all scholarships, awards and bursaries can be found on SAMS.

General Awards for Continuing Undergraduate Students continued... Complete these sections

Evelyn Krahn 1998 Scott Legacy Scholarship 2, 3

Friends of the University of Regina - Aboriginal Student Bursary 1

Friends of the University of Regina - Undergraduate Award

Garth Edward Usick Memorial Bursary 1

Garth Garver Memorial Award 1, 2

Grand and Toy Bursaries 1

Grant Mitchell Memorial Bursary I am a member of a cooperative organization or group. Please submit your membership number or a letter of membership from the organization or group.

1, 2, 3

Gregory J. Fieger Rams Football Scholarship Application must include 2 reference letters outlining student’s sport leadership and community involvement.

2, 3

Hindu Samaj Award

India Canada Association of Saskatchewan Scholarship I am of Indo-Canadian heritage.

2, 3

International Mobility Scholarships

J.A. Toupin Memorial Scholarship I am an employee, former employee, or immediate family member of an employee of Viterra (formerly Saskatchewan Wheat Pool).

Resident of Saskatchewan since: Month: _________________ Year: _____________

2, 3

Jennifer and Michelle Brehm Memorial Scholarship I am a single custodial parent. Number of dependents: _______

Jim and Elizabeth Ottley Award 1, 2

Kiwanis Van Cleave Bursary 1

Leopold Crescent Environmental Awareness Bursary 1, 2

Mary Sutherland Memorial Scholarship

Maurice Neitzel Awards 1

Meshsem Scholarship

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6 2014 Fall Application for Undergraduate Awards

Student Awards & Financial Aid

Enrolment Services

Selection of Undergraduate Awards (continued) UR Student ID Number

Please indicate with a checked box the awards for which you meet the criteria and wish to be considered. Ensure that you provide any

additional information that may be required in the application package as outlined in the description for the award.

Full descriptions and values for all scholarships, awards and bursaries can be found on SAMS.

General Awards for Continuing Undergraduate Students continued... Complete these sections

Milnor Alexander Award for Women 1, 2, 3

Morley Wood Memorial Scholarship for Aboriginal Female Students Application must include a 250-word or less statement of contributions to date with respect in promoting Aboriginal women in com munity-based or regional Aboriginal projects or programs.

1, 3

Mrs. J.W. Smith Scholarship 2, 3

Old Dutch Foods Ltd. Scholarship 1

Pat Moir Award

Pearl and Max B. Herman Bursary 1

Phoenix Group Athletic Award Resident of Saskatchewan since: Month: ______________ Year: _______________

2, 3

Project Hero Applicants will be required to provide documentation as indicated on the website posting for this award.

SACL Research Bursary 2, 3

SaskGaming Award Applicants must submit a separate 500 word essay with their application which clearly outlines their career goals in their area of study.

1

SaskGaming Community Leadership Award

Applicants must submit a separate 500 word essay with their application which clearly outlines their community involvement.

1, 3

SaskGaming Dependents Award I am a dependent of a Saskatchewan Gaming Corporation Employee and can provide proof of this.

1

Shandong Scholarship Fund Application must include a short essay explaining how participating in an exchange program to study at Shandong University will benefit his/her university

studies, personal growth and career aspirations.

Shirley Grant Memorial Award I am affiliated with a Regina Safeway. Please state in what way you are affiliated (i.e. employee): ______________________________________

Simon Yu Bursary 1

T.D. Bank Group Bursary in Energy and Environmental Studies 1

T.D. Brown Saskatchewan Student Loan Bursary 1

TD Insurance Meloche Monnex Scholarship in Community Service 2, 3

Timmons Mason Endowment 1

University of Regina Aboriginal Athletic Award 2, 3

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7 2014 Fall Application for Undergraduate Awards

Student Awards & Financial Aid

Enrolment Services

Selection of Undergraduate Awards (continued) UR Student ID Number

Please indicate with a checked box the awards for which you meet the criteria and wish to be considered. Ensure that you provide any

additional information that may be required in the application package as outlined in the description for the award.

Full descriptions and values for all scholarships, awards and bursaries can be found on SAMS.

General Awards for Continuing Undergraduate Students continued... Complete these sections

University of Regina Aboriginal Bursary I am receiving funding from my band.

1

University of Regina Alumni Association Children of Alumni Entrance and Retention Scholarship Name of Alumnus parent: _______________________________________________

2, 3

University of Regina Alumni Association Donald O. Wells and Deborah Wells International Study Award Application must include letter of acceptance to a University of Regina Exchange Program for the current Fall semester.

University of Regina Alumni Association Dr. John Archer Scholarship

University of Regina Alumni Association Leadership Awards 2, 3

University of Regina Alumni Association Scott Irving Spirit Award Application must include cover letter, resumé, and two letters of reference.

2, 3

University of Regina Faculty Association Dr. Peter Hemingway Memorial Bursary 1

University of Regina Faculty Association Faye Rafter Bursary I am a single custodial parent. Number of dependents: _________

1

University of Regina Family Scholarship

Students who apply and meet the scholarship’s minimum eligibility requirements can receive the full value of this scholarship as a benefit under each eligible

parent’s plan.

Employee member name:____________________________________________________ _______________ Employee’s number: _________________________________________

Relationship to employee: ____________________________________________________

Employee member name:____________________________________________________ _______________ Employee’s number: _________________________________________

Relationship to employee: ____________________________________________________

University of Regina Students’ Union Scholarship 2, 3

University of Regina Undergraduate Single Parent Bursary I am a single custodial parent. Number of dependents: _________

1

Willa Haughton Athletic Award 2, 3

Faculty of Arts Complete these sections

Bill Harding School of Human Justice Memorial Bursary Application must include statement of student’s learning goals addressing the interrelations of social justice, peace, and ecological sustainability. Application

must also include proposal stating rationale of program and relevance to student’s work.

1

Charles Bruce McPherson Bursary

I am residing in Saskatchewan 1, 2, 3

Department of Economics Award for Distinguished Public Service and Academic Excellence Application must include contact information for 2 references (Name, Phone Number, E-mail Address).

1. Name ___________________________________________________ Ph: ____________________________________ Email: _____________________________________________________

2. Name ___________________________________________________ Ph: ____________________________________ Email: _____________________________________________________

2, 3

Page 8: 2014 Fall Application for Undergraduate Awards 2014 application.pdf · Brady Salloum Memorial Scholarship Application must include a copy of correspondence from the Ministry of Advanced

8 2014 Fall Application for Undergraduate Awards

Student Awards & Financial Aid

Enrolment Services

Selection of Undergraduate Awards (continued) UR Student ID Number

Please indicate with a checked box the awards for which you meet the criteria and wish to be considered. Ensure that you provide any

additional information that may be required in the application package as outlined in the description for the award.

Full descriptions and values for all scholarships, awards and bursaries can be found on SAMS.

Faculty of Arts continued... Complete these sections

Department of Philosophy and Classics Scholarship

Dorothy Pogany Memorial Bursary 1

Dr. K. Oh Scholarship in Religious Studies Application must include a short essay of 250 words demonstrating an interest in comparative religious studies.

Dr. Leona Anderson Religious Studies Essay Prize

Application must be accompanied by student’s original essay.

Dr. Ralph Nilson Scholarship in Health Studies

Dr. William Howard Memorial Scholarship 2, 3

Family Life Saskatchewan Book Prize in Human Justice 1

Gladys Arnold Bursary in Journalism

Application must include a separate 500-word essay citing how the bursary would assist the student in the pursuit of their jour nalistic career. I know at least one language in addition to English.

1

Goldman Travel Assistance Fund Application must include documentation regarding the conference or workshop and a letter of recommendation from a Faculty member. The reference letter must be sent directly from your referee and will not be accepted as part of the application package submitted by the applicant. I agree to complete a brief follow-up report regarding the conference and submit it to the Dean’s Office in the Faculty of Arts once I have returned from

travel.

International Languages Award in Chinese, German, Spanish and Japanese 1

Japanese Studies Award 1

Johnsie Christina McPherson Bursary I am residing in Saskatchewan

1, 2, 3

Ken Mitchell Scholarship in Creative Writing Applicant must submit a 20-page portfolio of creative writing in one or more genres, along with a 1-page artist’s statement that summarizes the writer’s aims and methods in the work submitted.

Leonard Schein Honours Prize in Psychology I have applied for Graduate Studies.

Margaret Belcher Travel Scholarship Applicant must provide proof of intent to study French at an accredited institution in Canada or abroad.

Marijo Kinzel Bursary 1, 2, 3

Marshall Owen Lundlie Memorial Scholarship in French

Mary Lou Ogle Scholarship for the Study of Communications I am a resident of Saskatchewan

1

Mr. K. L. Kwong Memorial Scholarships in Ethics

Page 9: 2014 Fall Application for Undergraduate Awards 2014 application.pdf · Brady Salloum Memorial Scholarship Application must include a copy of correspondence from the Ministry of Advanced

9 2014 Fall Application for Undergraduate Awards

Student Awards & Financial Aid

Enrolment Services

Selection of Undergraduate Awards (continued) UR Student ID Number

Please indicate with a checked box the awards for which you meet the criteria and wish to be considered. Ensure that you provide any

additional information that may be required in the application package as outlined in the description for the award.

Full descriptions and values for all scholarships, awards and bursaries can be found on SAMS.

Faculty of Arts continued... Complete these sections

Religious Studies Founder’s Scholarship 2, 3

Rose Jeanne Souillart Clay and Pierre P.F. Clay Scholarship in French

Ross Harold Wotten Scholarship in the School of Journalism Application must include a written statement of expenses relative to internship honorarium to be received.

Sam and Bella Mills History Scholarship

TD Bank Group Bursary in Energy and Environmental Studies 1

University of Regina German Language Entrance Scholarship I am a non-native speaker of German.

University of Regina German Language Experience Award Application must include proof of application or acceptance into either the Student Exchange Program, the Canadian Summer School in Germany, or any other

recognized language learning program in a country where German is an official language.

I am pursuing a major, minor, or certificate in German.

University of Regina Women’s Centre Bursary in Women’s Studies 1

Faculty of Business Administration

(Please identify your intended major: ___________________________) Complete these sections

Alice M. Parent Memorial Bursary 1, 2, 3

Chartered Accountants of Saskatchewan Bursary in Memory of J.C. MacKinnon I intend to seek admission into the CA School of Business. I have accepted an offer of employment from an approved training office in Saskatchewan.

1

Chartered Accountants of Saskatchewan Scholarship

I intend to seek admission into the CA School of Business. I have accepted an offer of employment from an approved training office in Saskatchewan.

D.E. and M.W. Cuddington Scholarship Resident of Saskatchewan since: Month: __________ Year: ____________

1, 2, 3

Dale and Janet Schoffer Scholarship in Business Administration I am a single custodial parent. Number of dependents: ___________

1

Dr. Bonnie Dupont Women Inspiring Leadership Award 2, 3

Dr. Lloyd Barber Scholarships

Elaine and Paul Bourassa Bursary in Business Administration 1

EVRAZ Inc. NA Canada Scholarship in Business Administration

Faculty of Business Administration Aboriginal Student Award

Page 10: 2014 Fall Application for Undergraduate Awards 2014 application.pdf · Brady Salloum Memorial Scholarship Application must include a copy of correspondence from the Ministry of Advanced

10 2014 Fall Application for Undergraduate Awards

Student Awards & Financial Aid

Enrolment Services

Selection of Undergraduate Awards (continued) UR Student ID Number

Please indicate with a checked box the awards for which you meet the criteria and wish to be considered. Ensure that you provide any

additional information that may be required in the application package as outlined in the description for the award.

Full descriptions and values for all scholarships, awards and bursaries can be found on SAMS.

Faculty of Business Administration continued... Complete these sections

Financial Executives International– Regina Chapter Scholarship

Freedom 55 Financial Scholarship 2, 3

Hillberg & Berk Foundation Award 1, 2, 3

Joan and Adam Niesner Family Fund Bursary 1

John Deere Foundation of Canada Award

MNP LLP Scholarship 2, 3

Ottenbreit Award In Business Administration 1

Paul and Carol Hill Scholarship in Business Ethics 2, 3

Professor Neil Southam Memorial Scholarship I have completed a minimum of 2 years in another program

Saskatchewan Association of Human Resource Professionals Scholarship I am a graduate of a Saskatchewan high school. I am a member of SAHRP.

2, 3

Supply Chain Management Association Saskatchewan Award 2

Sylvia Aumuller Awards Fund 1

Teal Lowery Scholarship

University of Regina Women — Sandra Flegel Bursary 1, 2, 3

Centre for Continuing Education Complete these sections

All Saints Anglican English as a Second Language Bursary 1

Canadian Public Relations Society– Regina Chapter Scholarship

Centre for Continuing Education Certificate Awards I am not participating in a tuition reimbursement program.

Dr. Jack Boan Student Refugee Award I entered Canada under the auspices of the United Nations High Commission for Refugees (UNHCR).

I have just completed a year of sponsorship as a World University Service of Canada (WUSC) Student Refugee Program (SRP) stud ent.

I am a refugee student who came directly to the University of Regina through World University Service of Canada (WUSC).

I am still receiving tuition support from WUSC.

Page 11: 2014 Fall Application for Undergraduate Awards 2014 application.pdf · Brady Salloum Memorial Scholarship Application must include a copy of correspondence from the Ministry of Advanced

11 2014 Fall Application for Undergraduate Awards

Student Awards & Financial Aid

Enrolment Services

Selection of Undergraduate Awards (continued) UR Student ID Number

Please indicate with a checked box the awards for which you meet the criteria and wish to be considered. Ensure that you provide any

additional information that may be required in the application package as outlined in the description for the award.

Full descriptions and values for all scholarships, awards and bursaries can be found on SAMS.

Faculty of Education Complete these sections

Alice Mary Goodfellow Scholarship for Piano

Alice May Coldwell Education Scholarship I am a graduate of a Saskatchewan high school.

1

Amber MacLeod Scholarship in Special Education

Beverley Shore Memorial Music Scholarship in Arts Education 2, 3

n/a Bourse d'admission au Baccalauréat en Éducation Française Please see French

application on the SAFA

website.

Children on the Move Scholarship 2, 3

Colette Kokesch Scholarship 1

Dr. Don Kapoor Scholarship 1

Dr. Mary Cronin Literacy Scholarship 1, 2, 3

Faculty of Education Bursary 1

Florence & Grace Donison Bursary in Education 1

n/a Laura & Paul van Loon Bursary Please see French application on the SAFA website.

Marijo Kinzel Bursary 1, 2, 3

Marlene (Wood) Steininger Memorial Scholarship in Education Application must include a one page essay outlining the applicant’s passion for teaching young readers.

Muriel Welwood Scholarships for Women in Education 1

Sask Sport Glenn Tuck Memorial Scholarship Program 2, 3

Superannuated Teachers of Saskatchewan, Regina Chapter Tuition Bursary 1, 2, 3

University of Regina Faculty Association Dr. Sarah Shorten Memorial Scholarship 1, 2, 3

Wascana Preceptory No. 51 Knights Templar Scholarship Application must include a statement of scholastic merit from a Faculty member.

I am a graduate of a Saskatchewan high school.

2, 3

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12 2014 Fall Application for Undergraduate Awards

Student Awards & Financial Aid

Enrolment Services

Selection of Undergraduate Awards (continued) UR Student ID Number

Please indicate with a checked box the awards for which you meet the criteria and wish to be considered. Ensure that you provide any

additional information that may be required in the application package as outlined in the description for the award.

Full descriptions and values for all scholarships, awards and bursaries can be found on SAMS.

Faculty of Engineering and Applied Science Complete these sections

Association of Professional Engineers & Geoscientists of Saskatchewan (APEGS) Undergraduate Scholarship 2, 3

Brownlee Beaton Kreke Scholarship in Engineering Resident of Saskatchewan since: Month: _____________ Year: ____________

2, 3

Canadian Association of Petroleum Producers Bursary 1

Carl Potzus Award in Engineering

Application must include a one-page essay outlining your program and career plans and how they demonstrate an interest in highways and transportation.

Crescent Point Scholarship in Petroleum Systems Engineering

Dr. Derril McLeod Environmental Systems Scholarship in Engineering and Applied Science 2

Engineering Leadership Award 2, 3

EVRAZ Inc. NA Canada Scholarship in Engineering and Applied Science

Friends of the University of Regina—Engineering and Applied Science Award

Gordon R. Arnott Memorial Bursary 1

Helen Mary Morris Award for Women in Engineering I graduated from a Western Canadian high school.

1

Innovation Place Regina Aboriginal Scholarship

John Deere Foundation of Canada Award

John M. Forbes Bursary 1

Michelle Dolman Memorial Scholarship 2, 3

Regina Engineering Society Scholarship 2, 3

Regina Geotechnical Group Scholarship

SaskPower Awards

Resident of Saskatchewan since: Month: ______________ Year: ______________ 2,3

SED SYSTEMS, A Division of Calian Ltd. Scholarship 2, 3

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13 2014 Fall Application for Undergraduate Awards

Student Awards & Financial Aid

Enrolment Services

Selection of Undergraduate Awards (continued) UR Student ID Number

Please indicate with a checked box the awards for which you meet the criteria and wish to be considered. Ensure that you provide any

additional information that may be required in the application package as outlined in the description for the award.

Full descriptions and values for all scholarships, awards and bursaries can be found on SAMS.

Faculty of Engineering and Applied Science continued... Complete these sections

Shell Canada Aboriginal Award in Computer Science and Engineering 2, 3

SPE Canadian Educational Trust Fund (SPECET) Awards

I am a student member of the Society of Petroleum Engineers (SPE)

1

TD Bank Group Bursary in Energy & Environmental Studies 1

University of Regina Faculty Association Dr. Sarah Shorten Memorial Scholarship 1, 2, 3

Wil Mechanical Inc Scholarship 1

Faculty of Fine Arts Complete

these sections

Alice M. Parent Memorial Bursary 1, 2, 3

Alice Mary Goodfellow Scholarship for Piano

Alice Rhea Macredie Scholarship in Visual Arts

Bourse Bernard Lavigne Scholarship Media Production et/and Studies I am of French Canadian Heritage and have a command of French OR I have a demonstrated command of both of Canada’s official l anguages.

Fine Arts Entrance Award in Theatre

Application must include an essay (2 pages) on the topic “Theatre is Important Because”.

Gabe Prendergast Scholarship in Technical Theatre 2

Gene B. Ciuca Memorial Scholarships The Fall 2014 competition is only open to Visual Arts and Theatre students. The Winter 2015 competition will be open to students in each of the 4 departments.

Application must include 2 confidential letters of reference supporting ability in chosen field. References must be sent dire ctly from the referee and will not be accepted as part of the application package submitted by the applicant.

Kate Davis Scholarship in Curatorial Studies

Kiley Carlson Memorial Scholarship Application must include 2 pieces of original artwork submitted to the Visual Arts Department by the application deadline.

Kiyomi Annette Shoyama Bursary in Visual Arts 1, 2, 3

Larry Day Scholarship in Media Production and Studies

Application must include a separate 500-word statement explaining why the student is deserving of the scholarship and/or describing their vision for their future

career.

Marijo Kinzel Bursary 1, 2, 3

Mearl and Gaynel McCaw Memorial Scholarship in Fine Arts For the 2014 award year, this scholarship will be awarded to a Visual Arts student.

Shirley Andrist Bursary in Music 1

Wascana Preceptory No. 51 Knights Templar Scholarship

Application must include a statement of scholastic merit from a Faculty member.

I am a graduate of a Saskatchewan high school.

2, 3

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14 2014 Fall Application for Undergraduate Awards

Student Awards & Financial Aid

Enrolment Services

Selection of Undergraduate Awards (continued) UR Student ID Number

Please indicate with a checked box the awards for which you meet the criteria and wish to be considered. Ensure that you provide any

additional information that may be required in the application package as outlined in the description for the award.

Full descriptions and values for all scholarships, awards and bursaries can be found on SAMS.

Faculty of Kinesiology and Health Studies Complete these sections

Aboriginal Kinesiology and Health Studies Award 2, 3

Children on the Move Scholarship 2, 3

D.E. and M.W. Cuddington Scholarship Resident of Saskatchewan since: Month: __________ Year: ____________

1, 2, 3

Dr. Bill Clarke Scholarship in Recreation and/or Sport Administration I am a graduate of a Saskatchewan high school.

2, 3

Dr. Don Clark Scholarship

Dr. Ernie Nicholls Scholarship in Recreation and/or Sport Administration 3

Dr. Mary Bluechardt Scholarship 2, 3

Dr. Ralph Nilson Scholarship in Health Studies

Dr. Sandra Schmirler Scholarship

I graduated from a Saskatchewan high school.

2

Eli Gleiberman Scholarship in Adapted Movement Science 2, 3

Farden/Nilson Memorial Scholarship 2, 3

Ferguson Alumni Scholarship for Adapted Movement Science and/or Therapeutic Recreation Application must include a letter of reference from the employer or volunteer organization and a letter of reference from an instructor of KIN 120/SRS 120

(KHS 190). Reference letters must be sent directly from the referee and will not be accepted as part of the application package submitted by the applicant.

2, 3

Kinesiology and Health Studies Employees Student Bursary 1, 2, 3

Millard KHS International Fieldwork Placement Award 2, 3

NASSM Scholarship in Recreation and Sport Management Application must include your resumé.

2, 3

Neil Sherlock Scholarship 2, 3

Professor Fyola Lorenzen Scholarship

Professor Gene Rizak Scholarship

Sask Sport Glenn Tuck Memorial Scholarship Program 2, 3

Saskatchewan Parks and Recreation Association Award Resident of Saskatchewan since: Month: _____________ Year: ______________

2, 3

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15 2014 Fall Application for Undergraduate Awards

Student Awards & Financial Aid

Enrolment Services

Selection of Undergraduate Awards (continued) UR Student ID Number

Please indicate with a checked box the awards for which you meet the criteria and wish to be considered. Ensure that you provide any

additional information that may be required in the application package as outlined in the description for the award.

Full descriptions and values for all scholarships, awards and bursaries can be found on SAMS.

Faculty of Nursing Complete these sections

Against the Odds: Faculty of Nursing Deans Award

Application must include a 500 word essay describing your struggle with a difficult circumstance and why you would benefit fr om this award.

1

Friends of the University of Regina — Nursing Award

Saskatchewan Registered Nurses’ Association Award 1

Faculty of Science Complete these sections

Association of Professional Engineers & Geoscientists of Saskatchewan (APEGS) Entrance Bursary 1

Association of Professional Engineers & Geoscientists of Saskatchewan (APEGS) Undergraduate Scholarship 2, 3

Canadian Association of Petroleum Producers Bursary 1

Co-operators Life Insurance Company Actuarial Science Award 2, 3

D.E. and M.W. Cuddington Scholarship Resident of Saskatchewan since: Month: __________ Year: ____________

1, 2, 3

Department of Economics Award for Distinguished Public Service and Academic Excellence Application must include contact information for 2 references (Name, Phone Number, E-mail Address).

1. Name ___________________________________________________ Ph: ____________________________________ Email: _____________________________________________________

2. Name ___________________________________________________ Ph: ____________________________________ Email: _____________________________________________________

2, 3

Dr. Suzanne Marcia Nilson Scholarship in Biology

Enerplus Corporation Oil and Gas Scholarship 1, 2

Innovation Place Regina Aboriginal Scholarship

Muriel E. Finlayson Undergraduate Environmental Science Scholarship Application must include a one-page essay outlining your program and career plans and how they demonstrate a strong focus in environmental science.

Peter J. Puckall Memorial Bursary in Computer Science Application must include a detailed summary, not to exceed one page, on current interests in computing and/or business, computer related activities both in and

outside of the university. I am a graduate of a Saskatchewan high school.

1

SaskPower Awards Resident of Saskatchewan since: Month: ______________ Year: ______________

2, 3

SED Systems, A Division of Calian Ltd. Scholarship 2, 3

Shell Canada Aboriginal Award in Computational Science and Engineering 2, 3

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16 2014 Fall Application for Undergraduate Awards

Student Awards & Financial Aid

Enrolment Services

Selection of Undergraduate Awards (continued) UR Student ID Number

Please indicate with a checked box the awards for which you meet the criteria and wish to be considered. Ensure that you provide any addi-

tional information that may be required in the application package as outlined in the description for the award.

Full descriptions and values for all scholarships, awards and bursaries can be found on SAMS.

Faculty of Science continued...

Complete these sections

Shell Canada Scholarship in Computer Science 2, 3

SPE Canadian Educational Trust Fund (SPECET) Awards

I am a student member of the Society of Petroleum Engineers (SPE)

1

TD Bank Group Bursary in Energy and Environmental Studies 1

University of Regina Faculty Association Dr. Sarah Shorten Memorial Scholarship 1, 2, 3

Wascana Preceptory No. 51 Knights Templar Scholarship Application must include a statement of scholastic merit from a Faculty member.

I am a graduate of a Saskatchewan high school.

2, 3

Faculty of Social Work

Complete these sections

Carolyn Herperger Bursary I am a single custodial parent. Number of dependents: ______

I am a married parent with dependents. Number of dependents: ______

1

E.B. Elaine Meadows Memorial Bursary in Social Work

1

Faculty of Social Work Legacy Bursary 1

John Fullerton Middlemiss Scholarship

Marijo Kinzel Bursary 1, 2, 3

Maslany Award

Paige A. Brady Memorial Scholarship

2, 3

Robyn Mason Gavel Memorial Bursary 1

Winnifred Fakis Scholarship in Social Work 2, 3

Institut français (please use the French application, which can be found on the Student Awards and Financial

Aid website, to apply for the following awards)

n/a Bourse d'admission au Baccalauréat en Éducation Française Please see French application on the SAFA website.

n/a Laura & Paul van Loon Bursary

Please see French application on the SAFA website.

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17 2014 Fall Application for Undergraduate Awards

Student Awards & Financial Aid

Enrolment Services

SECTION 1 - Financial Disclosure If you are applying for any awards with a financial need component, you must complete the attached declaration in order to be considered.

UR Student ID Number

Please provide information to the best of your knowledge at the time of application.

Have you applied/Are you receiving Government Student Loans for 2014-15 academic year? Yes No Expected amount: $

Expenses

Type of Expense Months in School Total Cost (for 4 months of school)

2014 Fall Planned Course Load: Choose value from Chart A below (includes tuition, fees and books)

$ × credit hours

Saskatchewan Student Living Allowance: Choose one option below (includes shelter, food, transit, utilities, childcare, personal healthcare, clothing and communications)

Single student living away from home $4448 total for 4 months

Single student living at home $1916 total for 4 months

Single parent student: number of dependants: ____ $6016 + $2004/dependant

Married student & spouse: number of dependants: ____ $8676 + $2004/dependant

Other Expenses: (Provide explanation) × 4

TOTAL EXPENSES

Resources

Type of Resource (For use in this academic term) Total Funds

Personal Savings

Parental/Spousal Contribution (if applicable)

Expected Income (September-December)

Scholarships, Awards and Bursaries received

Investments/Assets (e.g. RRSPs)

Government Benefits (e.g. social assistance)

Third Party Funding (e.g. Band Funding, WHL, etc.)

Other Income: (e.g. RESPs) amount to be used for this academic term

Other Income 2: (Provide explanation)

TOTAL RESOURCES

CHART A: FACULTY TUITION, FEES & BOOKS per credit hour

Arts $ 265.10

Business Administration $ 314.02

Education $ 296.38

Engineering & Applied Science $ 311.02

Fine Arts $ 277.93

Kinesiology & Health Studies $ 280.27

Nursing $ 353.57

Science $ 286.60

Social Work $ 267.52

Fees are based on 2014-2015 rates and are subject to change. Additional Comments you may choose to disclose

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18 2014 Fall Application for Undergraduate Awards

Student Awards & Financial Aid

Enrolment Services

SECTION 2 - Personal Statement Statement may be maximum 1 page, single sided. May be handwritten below or submit a separate typed or handwritten page with application.

UR Student ID Number

Only one personal statement is to be submitted and must contain all additional information required for all awards for which you are applying.

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19 2014 Fall Application for Undergraduate Awards

Student Awards & Financial Aid

Enrolment Services

SECTION 3 - Summary of Extra-curricular Involvement, Community and Volunteer Service

UR Student ID Number

List in chronological order your most recent activities / involvement as required by all awards for which you are applying. Please indicate if the activity was for a class (C), paid employment (E) or volunteer (V). If the activity was over multiple years, please include the number of months per year that you were involved in the activity.

Extra-Curricular Involvement at School

Activity/Position Club/Team/Group Start Date Hours per Day, Week or Month as appropriate

End Date C, E,

or V

Community and Volunteer Service Outside of School

Role/Position Organization Start Date End Date Hours per Day, Week or Month as appropriate

C, E,

or V

Page 20: 2014 Fall Application for Undergraduate Awards 2014 application.pdf · Brady Salloum Memorial Scholarship Application must include a copy of correspondence from the Ministry of Advanced

20 2014 Fall Application for Undergraduate Awards

Student Awards & Financial Aid

Enrolment Services

SECTION 4- Financial Disclosure for CIC Aboriginal Bursary only

UR Student ID Number

Please provide information to the best of your knowledge at the time of application.

Have you applied/Are you receiving Government Student Loans for 2014-15 academic year? Yes No Expected amount: $

Expenses

Type of Expense Months in School Total Cost (for 4 months of school)

2015 Winter Planned Course Load: Choose value from Chart A below (includes tuition, fees and books)

$ × credit hours

Saskatchewan Student Living Allowance: Choose one option below (includes shelter, food, transit, utilities, childcare, personal healthcare, clothing and communications)

Single student living away from home $4448 total for 4 months

Single student living at home $1916 total for 4 months

Single parent student: number of dependants: ____ $6016 + $2004/dependant

Married student & spouse: number of dependants: ____ $8676 + $2004/dependant

Other Expenses: (Provide explanation) × 4

TOTAL EXPENSES

Resources

Type of Resource (For use in this academic term) Total Funds

Personal Savings

Parental/Spousal Contribution (if applicable)

Expected Income (September-December)

Scholarships, Awards and Bursaries received

Investments/Assets (e.g. RRSPs)

Government Benefits (e.g. social assistance)

Third Party Funding (e.g. Band Funding, WHL, etc.)

Other Income: (e.g. RESPs) amount to be used for this academic term

Other Income 2: (Provide explanation)

TOTAL RESOURCES

CHART A: FACULTY TUITION, FEES & BOOKS per credit hour

Arts $ 265.10

Business Administration $ 314.02

Education $ 296.38

Engineering & Applied Science $ 311.02

Fine Arts $ 277.93

Kinesiology & Health Studies $ 280.27

Nursing $ 353.57

Science $ 286.60

Social Work $ 267.52

Fees are based on 2014-2015 rates and are subject to change. Additional Comments you may choose to disclose