.:Blyth Scholars:.-Scholarship Application

Please fill out all fields of the application.

Personal Information

Last Name	Tel.
First Name	E-mail
Address	D.O.B.
Apt.	Gender	Female Male
City	Citizenship
Province
Postal

Academic Information

High School Name

Courses Taken
(one per line)

Address

Suite/Unit

City

Please List Important academic accomplishments.

Province

Postal

Please paste your 1000 word essay below. The essay should be an exploration of a topic which relates directly to the discipline you are applying to study.

Academic Achievement

Submit all of the following below through the file upload window:

1. An up to date transcript (credit counselling summaries are not acceptable).
2. Your most recent report card.
3. Two letters of support from your teachers and one letter from a member of your community.

Personal Information

Submit all of the following below through the file upload window:

1. Proof of citizenship (Birth Certificate or Passport)
2. A passport sized photo

If you are elected as a scholarship recipient, do you agree to allow your name and biographical information to be released to the scholarship contributor and to be used in any publication associated with the scholarship?

NoYes

TRANSCRIPTS, REPORT CARDS, LETTERS OF REFERENCE & APPLICANT PHOTO SHOULD BE UPLOADED BELOW IN THE FOLLOWING FORMAT:

lastname_firstname_documenttype

Example: John Smith's photo should be named: smith_john_photo.jpg

PLEASE DO NOT OMIT to submit both a UCAS form and a Cambridge Application Form. The Cambridge Application Form must be returned by October 15th 2008 directly to Pembroke and the UCAS Form must be completed between 1 September and the closing date of 15 October.

Transcript
Report Card
Ref. Letter 1
Ref. Letter 2
Ref. Letter 3
Proof of Citizenship
Applicant Photo