Congress of Black Women of Canada
Ajax/Pickering Chapter
CBWC 2015
Ajax/Pickering Adult Scholarship
Application Package
The Congress of Black Women of Canada – Ajax/Pickering Chapter announces the
inauguration of its ‘Adult Scholarship’.
Purpose:
To offer financial assist to a single mother who has identified the need to return to school to further
her education.
Amount of scholarship:
Application deadline:
Presentation date:
$1,000.00
April 30, 2015
June 14, 2015
(recipient must attend the award ceremony)
Eligibility:

You are an Adult African-Canadian Single Mother twenty years of age or older pursuing postsecondary education

Canadian Citizen or permanent resident, residing in Ajax/Pickering

Attended high school and is currently enrolled in a Canadian College, University or
Vocational/Technical Institution
Application Requirements:

A completed application form

An essay of not more than 500 words describing the reasons why you would be a worthy
recipient of the Congress of Black Women of Canada – Ajax/Pickering Adult Scholarship.
o Include your contribution to the Black community, other volunteer activities, and what
motivated you
o Your academic achievements, your most important accomplishments and your future
goals

A completed financial schedule stating budget, including information on expected sources of
funding (e.g. other scholarships received, student loan, etc.), family income and related
information to assist us in determining financial need.

2 letters of reference

Proof of registration to a recognized university, college, vocational/technical institution

One passport size photo (will become the property of CBWC and a 100 word statement about
you. These will be published in the program of the Scholarship Brunch.
Deadline for Applications:
Application and applicable supporting documents must be received no later than April 30, 2015.
Scholarship Selection Committee
Congress of Black Women of Canada
Ajax/Pickering Chapter
1556 Nipissing Court
Pickering ON L1V 6T9
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Applications are also available at: www.cbwc-ajaxpickering.org
Interview Process:
The Selection Committee will interview applicants the week of May 4th, 2015. The successful
applicant will be notified the week of May 11th, 2015. The success applicant must be present to
accept the award at the Congress of Black Women of Canada – Ajax/Pickering Annual Scholarship
Award Brunch presentation on June 14, 2015.
Conditions / Payment of Award
1. Payment of the Award will be made directly to the recipient (this is a one-time scholarship).
2. Award recipient must notify the Congress upon completion of course of study
3. Award recipient will be invited to participate at a future scholarship award and family brunch.
The Congress of Black Women Scholarship Committee wishes to thank you!
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CBWC 2015
Ajax/Pickering Adult Scholarship
Application Form
Congress of Black Women of Canada
Ajax/Pickering Chapter
Candidates must provide evidence of Academic Excellence, Community Involvement and Financial Need.
Deadline for submission of completed forms is on or before 5:00 pm April 30, 2015. Please type or print clearly.
Provide complete information. Be sure to sign and date application at appropriate place. If needed, feel free to use
additional sheets.). Marks required are for the current school year.
Section 1: Applicant Information
Name:
(Last)
(Middle)
(First)
Address:
(Unit no.)
(Street no.)
Telephone:
(
(Street name)
(City)
Date of Birth
Sex:
)
/
(Y)
(Postal code)
/
(M) (D)
Email Address:
(# of dependents)
(Age (s)
(Sex M/F)
Section 2: Post Secondary Institution Applied to or Attending
Name
Program
Major
Name
Program
Major
Name
Program
Major
Section 3: Community Involvement
Please describe your community/organization activities:
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Section 4: Financial Budget (Sources of Income and Expenses)
Please provide information
Section 5: Essay
Write a 500 word essay outlining why you think you should be chosen for this Scholarship/Award
Section 6: References
Please submit two Written References. (One reference must be from a School Official)
Name
Address
Occupation
Phone #
Name
Address
Occupation
Phone #
Signature:
Date:
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