SOCCER NOVA SCOTIA
APPLICATION
UNIVERSITY ENTRANCE SCHOLARSHIPS
DEADLINE: April 15th, 2014
Soccer Nova Scotia
Scholarship Application 2014
Soccer Nova Scotia is pleased to offer university
entrance scholarships to outstanding members of
Soccer Nova Scotia. The recipient must commence
post-secondary studies at a Canadian university or
college in the same year the award is presented.
Soccer Nova Scotia scholarships are entrance
scholarships and are not renewable. The
scholarships are awarded for one academic year, in
two equal amounts payable on September 7th and
January 4th respectively, upon proof of registration
at a university or college.
As an applicant for the Soccer Nova Scotia
scholarship, you must submit the following to the
address below.
1.
Complete application;
2.
High school transcripts (Grade 11 & Grade
12 to January);
3.
Small photograph of yourself for
publicity purposes.
Please mail the above documentation by April 15th,
2014, 5:00 p.m. to the attention of:
Successful recipients of Soccer Nova Scotia
scholarships must agree that a promotional
photograph of themselves can be used for
promotional purposes.
George Athanasiou, CEO
RE: Scholarship Applications
210 Thomas Raddall Drive
Halifax, NS, B3S 1K3
This year Soccer Nova Scotia will offer the following scholarships:
Hartlen Family Scholarship – Open to male players with strong soccer skills,
strong academics and a history of giving back through coaching and/or training
of others.
$500.00
(renewable for 4 years)
Frank H. Bailey Memorial Scholarship - Open to male players
in memory of long-time Soccer Nova Scotia President, Frank Bailey.
$600.00
Robert Sayer Scholarship - Open to female players
in honour of the first soccer inductee to the Nova Scotia Hall of Fame – Builder.
$600.00
Stephenie Allt Memorial Scholarship - Open to female players
in memory of a young outstanding person and player.
$600.00
VanRoy Tobitt Memorial Scholarship - Open to male referees
in memory of the first Nova Scotia-based referee to reach National level status.
$600.00
Carol Shadbolt Scholarship - Open to female referees
in honour of the first female soccer referee in Nova Scotia.
$600.00
Halifax King Of Donair Soccer Club Scholarship - Open to all members
in honor of the first Nova Scotia club team to be crowned National Champions.
$600.00
SOCCER NOVA SCOTIA
SCHOLARSHIP AWARDS APPLICATION 2014
Applicants must answer all questions on the application form. Appendices, extra pages or material such as
certificates or letter of recommendation may accompany the application. The completed application must
reach Soccer Nova Scotia no later than 5:00 p.m. on posted deadline date. ALL APPLICANTS MUST BE SOCCER
NOVA SCOTIA MEMBERS.
PLEASE CHECK THE SCHOLARSHIP YOU ARE APPLYING FOR:
Hartlen Family Scholarship
VanRoy Tobitt Memorial Scholarship
Frank H. Bailey Memorial Scholarship
Carol Shadbolt Scholarship
Robert Sayer Scholarship
Halifax King Of Donair Scholarship
Stephenie Allt Memorial Scholarship
1. GENERAL INFORMATION
Name:
Last
First
Birth Date:
Middle
Phone #:
dd/mm/year
Address:
Street # / P.O. Box
City/Town
Email Address:
Sex:
Postal Code
Male
Female
2. EDUCATIONAL BACKGROUND
High School(s) Attended:
Year(s)
Grade(s) School
Address
Diploma
Expected Date of Graduation:
Educational Plans for the next academic year. Please mark with an (X).
University
Community College
Post-Secondary Institution you plan to attend:
Proposed program of study:
Other
3. SOCCER OFFICIATING / PLAYING BACKGROUND (Past 5 Years)
Year
Category
Team (if player)
Association
List your soccer involvements, during the past five years (include awards, achievements, volunteer positions,
etc.):
List any other sport involvement:
4. SCHOOL ACTIVITIES
List extracurricular activities, including offices, athletics, clubs, volunteering and/or positions held (attach list
if necessary):
Awards, Recognition, additional Certifications (attach list if necessary):
Academic:
Athletic:
Certifications:
Other:
5. COMMUNITY SERVICE
Demonstrated service through active participation (non-school):
6. EMPLOYMENT BACKGROUND
Provide a chronological record of employment for the last 3 years:
CERTIFICATION
I hereby certify that the foregoing information is true and correct and can be verified upon request.
Signature of Applicant
Date
Signature of Parent/Guardian
Date
Applications must be received no later than 5:00 p.m. on posted deadline date:
SNS Scholarship Application
Attn: George Athanasiou CEO
210 Thomas Raddall Drive
Halifax, NS, B3S 1K3
Letter of Recommendation
To be filled out by an Employer, Guidance Counselor/Instructor, etc.
SECTION 1: Applicant Information
Name:
Student ID:
Address:
Phone:
e-mail:
SECTION 2: Recommendation
Organization:
Phone:
Name:
Title:
Address:
1. How long have you known the applicant? Years:
Months:
2. Relationship to the applicant:
3. Please give your personal appraisal of the applicant with regard to the following:
Attendance & Punctuality
Cooperation
Judgement
Initiative
Reliability
Work Ethic
Attitude
Excellent
Good
Average
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Needs
Improvement
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4. Please comment on the ability and accomplishments exhibited by the applicant. In addition, please
address why you are recommending them. (Please use and additional page if needed.)
Signature:
Date:
Please attach to application and send to:
Attn: George Athanasiou, CEO
Soccer Nova Scotia
210 Thomas Raddall Drive, Halifax, NS, B3S 1K3
Fax: 902-445-0258