Scholarship Application Form

Name:

Address:

City:

Province:

Postal Code:

Phone:

Email:

Post Secondary Institution currently attending:

Other institutions attend (if any):

Volunteering (if any):

Relationship to a Member in the Western Canada Chapter of the International Society of Explosives Engineers (Must be immediate family eg: mother, father, brother, sister, etc.):

Courses taking:
Previously taken courses:

Current GPA for the semester:

Cumulative GPA:

Why do you think you should receive this scholarship?

How will the scholarship benefit you?

Any comments:

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