Wolfe Family General Achievement
Entrance Scholarship Application Form
Applications must be received by 30 April 2015 and include four letters of reference, two in regards to the
applicants community service work, and two regarding involvement in sports activities.
Applications are submitted to: Scholarship Awards Committee, c/o Registrar’s Office, Campion College,
University of Regina, 3737 Wascana Parkway, Regina, SK S4S 0A2, or [email protected]
Inquiries: Dr. Leanne Groeneveld, Awards Officer, 306-359-1222
Award Cri teri a
The Wolfe Family General Achievement scholarship recognizes students who have demonstrated academic
excellence, human compassion through service within the community, and a commitment to athletics. To be
eligible, candidates must:
• be entering their first year of study in a direct-entry undergraduate degree program at Campion
College,
• have achieved an Early-Conditional admission average of 90% or greater,
• be a resident of Saskatchewan,
• graduate from a Saskatchewan high school
• and provide documentation attesting to:
 having devoted an average of at least two hours weekly over a 40 week
period during the prior year to compassionate activity(ies),
 having devoted an average of at least two hours weekly over a 40 week period
during the prior year of participation in individual or team sports and/or
athletics.
One entrance award valued at $6,500 will be awarded for the 2015/2016 academic year. This award is renewable
for up to three additional years with a renewable value of $6,500 per year. The potential value of the award is
$26,000.
To apply, students must submit a completed application form along with two letters of reference/ letter
testimonials confirming and describing the candidate’s compassionate activities* (at least two hours weekly
over 40 weeks during the prior year) and two references / letter testimonials confirming and describing the
candidate’s participation in individual or team sports and/or athletics.
*Note: Compassionate activities may include, but are not limited to, the following: assistance to or visiting of isolated, aged, weak, infirm, or
handicapped persons in their homes or community residence; tutorial assistance to socially disadvantaged or physically handicapped children;
community service.
Instructions
A.
Complete the application form. The file can be either saved and emailed, or printed and mailed, or
hand-delivered to the address above. (Note: Handwritten forms will NOT be accepted.) Please be
sure to include four letters of reference as outlined in the award criteria above.
B.
Completed applications must be received by 30 April 2015 to be considered for this scholarship.
S ECTION 1 – CONTACT INFORMATION & DECLARATION FORM
General Informati on
First Name:
Last Name:
Student Number:
Date of Birth (day/month/year):
Social Insurance Number:
Faculty:
Address:
City:
Telephone Number:
Prov:
Postal Code:
Cell Phone Number:
Email:
D ec larati on & Consent:
I declare that the information I have provided in this application is accurate and complete. I understand that all
information I have provided in connection with this application is subject to verification and audit by Campion
College, and agree to provide supporting documentation to the College to verify my eligibility upon request. I give
permission to Campion College to release personal information given in this application to other educational
institutions, and federal and provincial student loan offices to verify its completeness and accuracy. Should I be
selected to receive this award, I grant Campion College permission to provide my name, award, program of study,
year level and amount of my award to the donor of the award, my high school guidance counselor, and to the
Campion College Communication office for publication and promotional purposes. My photograph may also be
used for promotional purposes.
 Yes, I have read and agree to the above terms and conditions.
Signature:
Date:
Notice: Successful applicants will be required to sign a waiver of indemnity before funds are released.
S ECTION 2 – P ERSONAL S TATEMENT
S ECTION 3 – S UMMARY OF V OLUNTEER AND C OMMUNITY S ERVICE
Volunteer/ Community Service
Role/ Position
Organization
Start Date
End Date
Hours per
(mm/dd/yyyy)
(mm/dd/yyyy)
Day/Wk/Mth
S ECTION 4 – S UMMARY OF S PORT / A THLETIC I NVOLVEMENT
Sports/Athletic Activities
Activity/ Position
Team/ Organization
Start Date
End Date
Hours per
(mm/dd/yyyy)
(mm/dd/yyyy)
Day/Week/Mth