application form

The Kelvern Celtic Society is pleased to announce the establishment of a
STUDENT BURSARY effective September, 2015.
The Kelvern Bursary will be awarded to a student entering a post-secondary institution in
September of 2015.
Deadline For Applying.
This application should be forwarded by May 15 2015 to the Kelvern Celtic Society
mailing address (See below)
Qualification.
1. An applicant must be or have been a member of the Kelvern Celtic Society.
OR
2. Failing that, he/she must be able to verify a close relationship to a present or former
member of the Society.
Note to Applicant.
Please complete the following form. Print or key in the pertinent information.
Surname_____________________________________________________
First Name___________________________________________________
Middle Name_________________________________________________
DoB (D,M,Y) ________________________________________________
Address______________________________________________________
City_________________________________________________________
Postal Code___________________________________________________
Telephone_____________________________________________________
E-Mail_______________________________________________________
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Current secondary school___________________________________________
Location__________________________________________________________
Preferred (likely) post-secondary institution.______________________ _____
_________________________________________________________________
Location_________________________________________________________
Course of study___________________________________________________
What are your career goals? ________________________________________
_________________________________________________________________
_________________________________________________________________
In what way might this course of study help to prepare you for that
career?_______________________________________________________ ____
_________________________________________________________________
_________________________________________________________________
Please identify your affiliation with the Kelvern Celtic Society.
Are you currently a member? _______________________________________
Were you a member? ____________ In what year(s)?_______________ _____
In what member group did you participate? For example, the Kelowna
Pipe Band._______________________________________________ _________
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If you answered “NO” to the above questions, please identify a
relative who is/was a Kelvern member. ________________________________
Please provide contact information for that person for the purpose of
verification. Name, address, phone, e-mail etc._________________________
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
Should you require further information, please contact either:
Alan Stonehouse, Treasurer, [email protected] or
Paul Munroe, President, [email protected]
Please submit your application to the emails above or mail to:
Box 20127, Towne Centre Mall, Kelowna, BC V1Y 9H2
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