APPLICATION FORM FOR
THE UNION OF TAXATION EMPLOYEES SCHOLARSHIP
Postmarked or faxed by June 15th to:
The Union of Taxation Employees
Attn: U.T.E. Honours and Awards Committee
233 Gilmour Street Suite 800
Ottawa, Ontario
K2P 0P2
Fax: 613-234-7290
PART A – Applicant Information:
Name: _________________________________________________________________________
(LAST
NAME) (FIRST
NAME)
Address: _________________________________________________________________________
(NUMBER
AND STREET)
_________________________________________________________________________
(CITY) (PROVINCE) (POSTAL
CODE)
If you are a member, please provide P.S.A.C. ID# ____________________________
PART B – U.T.E. Member Information (if applicable):
Relationship to Applicant: Parent:
____
Spouse:____
Name: _____________________________________________ Local:
_________________________
Office Telephone: ____________________________________ City:
__________________________
P.S.A.C. ID # ________________________
_______________________________________ __________________________
Signature of Applicant Date
SECTION 1
STATEMENT PERTAINING TO PROGRAM AND CAREER PLANS:
What university/college/institute will you be attending? Please
include the name of the city.
______________________________________________________________________________________
What degree are you working towards?
______________________________________________________________________________________
What field do you contemplate entering following graduation?
______________________________________________________________________________________
______________________________________________________________________________________
SECTION 2
UTE SCHOLARSHIP – PERSONAL STATEMENT # 1
Postmarked or faxed by June 15th to:
The Union of Taxation Employees
Attn: U.T.E. Honours and Awards Committee
233 Gilmour Street, Suite 800
Ottawa, Ontario K2P 0P2
Fax: 613-234-7290
Statement on behalf of:
_____________________________________________________________
(Applicant’s
Name)
Evaluation of the applicant’s work and capabilities:
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
Appraisal of the applicant’s potential compared with his/her actual
achievement:
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
Evaluation of the applicant’s general character as revealed in your
association with him/her:
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
Submitted by: ________________________________ Title:
____________________
Signature: ____________________________________ Date:
___________________
SECTION 2
UTE SCHOLARSHIP – PERSONAL STATEMENT # 2
Postmarked or faxed by June 15th to:
The Union of Taxation Employees
Attn: U.T.E. Honours and Awards Committee
233 Gilmour Street, Suite 800
Ottawa, Ontario K2P 0P2
Fax: 613-234-7290
Statement on behalf of: _____________________________________________________________
(Applicant’s
Name)
Evaluation of the applicant’s work and capabilities:
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
Appraisal of the applicant’s potential compared with his/her actual
achievement:
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
Evaluation of the applicant’s general character as revealed in your
association with him/her:
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
Submitted by: ________________________________ Title:
____________________
Signature: ____________________________________ Date:
___________________
SECTION 3
STATEMENT OF COMMUNITY INVOLVEMENT:
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
SECTION 4
STATEMENT OF YOUR UNION INVOLVEMENT OR THAT OF YOUR SPOUSE OR PARENTS:
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
REQUIRED ATTACHMENTS:
-
A 500-700 word essay or submission in audio, visual
(painting, drawing, sculpture, or photograph) or video format per the
guidelines;
-
Proof of Registration of the University, College or
Institute of higher learning;
-
Transcript of your most current academic standing. This
is not applicable for anyone who has been out of school for more than
two (2) years and;
-
A 3” X 4” colour photograph of yourself
for use in announcing successful applicants.
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