Champlain Heights Community Centre
3350 Maquinna Drive, Vancouver, B.C. V5S 4C6
Phone: 604-718-6575
Fax: 604-718-6580
Website: www.champlainheightscc.ca
Champlain Heights Community Centre Leadership Scholarship Application
To be eligible for the scholarship, the applicant must:
• Be a current grade 12 student and will be graduating in June 2015
• Have contributed to the Champlain community and demonstrated leadership through community service
• Be pursuing a formal education within 8 months post-graduation
Full Name
Address
Phone Number
E-mail
____________________________________________________________________________________________________________
Name of Current School
Name of Elementary School Attended
Please use spaces provided to answer each question or attach responses on a separate page.
1. What are your strongest and weakest leadership skills? How has volunteering for the community helped you improve or
overcome your weakness?
2. Please describe how your role in your community involvement has impacted your career and education goals?
APPLICATION DEADLINE – May 15th, 2015 @ 6pm
Please return completed application to Champlain Heights Community Centre.
Champlain Heights Community Centre
3350 Maquinna Drive, Vancouver, B.C. V5S 4C6
Phone: 604-718-6575
Fax: 604-718-6580
Website: www.champlainheightscc.ca
3. What do you feel is your most significant contribution to this community?
4. What characteristic would you say makes you a strong applicant for this scholarship? (ie. Why should you be chosen for this
scholarship above other applicants?)
__________________________________________________________________________________________________________
APPLICANT’S SIGNATURE
DATE
APPLICATION DEADLINE – May 15th, 2015 @ 6pm
Please return completed application to Champlain Heights Community Centre.