LNS Scholarship Application Form

LNS Scholarship Application Form

PO Box 1516

Truro NS B2N 5V2

Phone: 902-897-2444

Fax: 902-897-4020

Email:

Website: www.literacyns.ca

Charitable Tax#: 139831697RR0001

2016 Scholarships

An opportunity for adult learners who have completed grade 12 through an adult learning program or GED and are continuing in a post-secondary program in the fall of 2016.

About the scholarship

Many adults are upgrading their education. They want to go to community college, university, or technical and trades programs. When going back to school, they may have a hard time managing family responsibilities, travel, and other costs. This year, two scholarships of $1500 each will be awarded to help with tuition, travel costs, and books. One of these scholarships will be awarded to a student attending the NSCC Truro Campus.

Who qualifies?

To qualify you must be an adult who:

· left the public school system before completing grade 12

· has received the GED or High School Diploma through an approved adult learning program

· has been accepted or is returning to university part-time or full-time OR a community college program OR a certified technical, trade or private trade school program in the fall of 2016. The program must be at least eight (8) months long.

How to apply

To apply for a scholarship you must:

· complete pages 1 and 2 of this application

· send your learning story

· sign and date the bottom of page 2

· send a copy of the letter from the school registrar confirming that you are accepted or enrolled for the year 2016 – 2017.

· send in two recommendation forms (see page 3 and 4) or letters from your instructors, tutors or employer

· mail or fax all of the above to:

Literacy Nova Scotia, PO Box 1516, Truro Nova Scotia, B2N 5V2

Fax: 902-897-4020

Deadline

Scholarship applications must be in the Literacy Nova Scotia office by 12:00 noon on October 21, 2016,

Only the successful applicants will be contacted by Literacy Nova Scotia on or before October 28, 2016.

About Literacy Nova Scotia

Literacy Nova Scotia (LNS) supports the literacy community in Nova Scotia. Our mission is to ensure that all Nova Scotians have equal access to quality literacy, essential skills, and lifelong learning opportunities.

Literacy Nova Scotia helps students, learners, tutors, instructors, volunteers and others to speak out on literacy issues.

In 1995, Literacy Nova Scotia started a scholarship fund to help adult students living in Nova Scotia. It is funded by part of the proceeds raised through the NS Peter Gzowski Invitational Golf Tournament for Literacy.

1. / Name
2. / Address with postal code
3. / Contact telephone numbers / Home / Cell
4. / Email address
5. / Do you live with your parents? / Yes / No
6. / How many children do you support?

Part 1 – Personal Information

Part 2 – Education Information

1. / Name of last public school attended
2. / Highest grade completed before leaving the public school system
What year?
3. / Have you attended an adult learning program, literacy or one-on-one tutor training course/program since you left the public school system? / Yes / No
If yes, please give the following information:
Program Name:
Location / Date
4. / Did you complete a GED? / Yes / No
5. / Did you receive the NS Adult High School Diploma? / Yes / No
6. / Will you be attending a community college, technical or trade school, private training program or university during the 2016/2017 school year? / Yes / No / Waiting to hear
Please give the following information:
Program Name
Location

Part 3 – Your story

Tell your own learning story in 200-250 words on a separate sheet of paper. Use this opportunity to tell us why you need this scholarship and remember to include the following information:
a. why you returned to school
b. some of the hardest things about going back
c. some of the best things about going back
d. what are your personal plans and/or
e. what are your career goals

Part 4 – Financial Information – Income and Expenses

1. / Total monthly income
Include your job, your spouse’s job, social assistance, child support, and any other income
2. / Are you receiving other scholarships, bursaries or student loans?
Please list them, including the amounts. / 1.
2.
3.
3. / Please list your monthly living expenses: / Rent/Mortgage / $
Childcare / $
Travel to school / $
Total / $
4. / How much is your tuition for one year?
5. / How much do you think your books and materials will cost?
6. / If you receive a scholarship, how will you use the money? For example: tuition, childcare, books, travel, etc. Please explain briefly:

Part 5 – Checklist and signature

I have completed parts 1 and 2 of this application.
I have completed part 3 of this application by writing my story in 200-250 words on a separate sheet of paper.
I have completed part 4 and 5 of this application.
I have provided the following 3 documents:
 1. A copy of the letter from the registrar of the school confirming that you are accepted or enrolled for the year 2016-2017.
 2. A letter of reference or the form on page 3 from your tutor, your instructor, or your employer
 3. A letter of reference or the form on page 4 from your tutor, your instructor, or your employer
Your agreement and signature.
Literacy Nova Scotia respects your privacy. As part of the celebration of learner awards, LNS may publish award winners’ names, photographs, quotes from essay submissions and the amount of the award. This does not include personal financial information.
By signing this application, you give Literacy Nova Scotia permission to publish your information.
The information I have provided is correct. ______(signature)
______(date)
Successful applicants are required to provide their Social Insurance Number to LNS in order to comply with Canada Customs and Revenue Agency rules and regulations.

Instructor, Tutor or Employer Recommendation Form

(to be filled out by tutor or instructor or employer)

Two recommendations are required

Please help us by providing some information about the person applying for the scholarship.

Student name
Program
Instructor, tutor, or employer name
Telephone number
Date
Could be better / Average / Above Average / Excellent / Not Applicable
Attendance
Attitude
Realistic Goals
Seeks to continually improve her/his knowledge and skills
Inspires others to work toward a common goal

REQUIRED

Please give us a brief appraisal of this learner that sets her/him apart from her/his classmates and prompted you to recommend her/him for this award. If you wish, you may attach a letter of reference.

Instructor, Tutor or Employer Recommendation Form

(to be filled out by tutor or instructor or employer)

Two recommendations are required

Please help us by providing some information about the person applying for the scholarship.

REQUIRED