Masonic Lodge of the Wales Home Health Scholarship

To honour their long time Masonic Brother Dudley Fraser, the members of the Masonic Lodge of the Wales Home are offering a scholarship to local health care students in a wide range of professions, e.g., doctors, nurses, therapists, special care counselling and technicians who intend to practice in the Eastern Townships.

ELIGIBILITY CRITERIA

Full-time student
Canadian citizen or permanent resident
Financial Need
Study program in health care
Ability to work in both French and English
Community Involvement

THE FOLLOWING DOCUMENTATION SHOULD ACCOMPANY THE COMPLETED FORM:

Copy of latest transcript
One signed letter of reference from a teacher attesting to your potential to work in your chosen field and your language skill.
Note: This document can be sent directly via email to the foundation from the teacher. This document may also be mailed via Canada Post directly to the Lampe Foundation. The address is on the form.
Proof of Canadian citizenship or Permanent Resident Status.
Proof of acceptance in a certification, degree or diploma program

This award is contingent upon the applicant providing proof of registration and remaining in an accredited post-secondary program.

Decisions of the Scholarship Selection Committee are final.
All information will be treated in strictest confidence

Application Deadlines

March 30
October 30

Award Amount

$1000

Full Name*
Prefix First Last
Present Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
How many years at this address?*
Permanent Address
- Same as present address
*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
How many years at this address?*
Home Phone Number*
Cell Phone Number
Email Address*
I am a:*
- Canadian Citizen
- Permanent Resident
High School Name*
High School Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Years Attended (YYYY - YYYY)*
Describe your intended course of study (institution, degree or diploma, field of study, length of program).*
Please explain your career goals:*
Describe your community involvement:*
Is there anything else you would like to tell us about yourself to help us select the successful applicant? This may include information about your personal circumstances.
Estimate your expenses for the next year (tuition, books, transportation, housing, child care, etc.)*
Click + icon to add more fields
Expense Estimate Cost ($)
Indicate your sources of support (personal savings, employment insurance benefits, manpower training measure, part - time income, parents or relatives, spouse or partner, loans, bursaries, etc.)**
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Income Source Estimate Income ($)
Copy of proof of Canadian citizenship or Permanent Resident status*
This can be a copy of a passport, birth certificate, PR Card, etc.
We are currently only accepting PDF copies of the files.
Max file size: 2MB
Accepted file types: pdf, Max. file size: 100 MB.
Copy of latest transcript*
We are currently only accepting PDF copies of the files.
Max file size: 2MB
Accepted file types: pdf, Max. file size: 100 MB.
Proof of acceptance in a certification, degree or diploma program*
We are currently only accepting PDF copies of the files.
Max file size: 2MB
Accepted file types: pdf, Max. file size: 100 MB.
Two (2) letters of reference, one from a teacher and one that should attest to the applicant’s barriers/obstacles for learning.
We are currently only accepting PDF copies of the files.
Max file size: 2MB
NOTE: These documents can be sent directly via email to hannbowman@hotmail.com.
Drop files here or

Accepted file types: pdf, Max. file size: 2 MB, Max. files: 2.
- Check this box if your teacher or employer will contact the foundation directly via email or if the document will be mailed.
Terms and agreement*
I certify that the information in this application is accurate and complete, to the best of my knowledge. If selected, I agree to have my name and place of study published on the CFUW Sherbrooke & District internet web site (cfuwsherbrooke.org),on Lampe Foundation website (www.lampefoundation.org) and on Lampe Foundation Facebook page.
- I agree to the terms and certify all all the above information is correct.
Email
This field is for validation purposes and should be left unchanged.

Expense	Estimate Cost ($)

Income Source	Estimate Income ($)