SOFIA SMILES SCHOLARSHIP APPLICATION

Section 1 - Contact Information

___________________________________


Parent/Guardian #1


Full Name

Relationship to Applicant

Size of Family Unit

Total Family Income

Mailing Address, Street Name

City

Province

Postal Code

Email


Parent/Guardian #2


Full Name

Relationship to Applicant

Size of Family Unit

Total Family Income

Mailing Address, Street Name

City

Province

Postal Code

Email


Section 2 - Letter of Intent

_____________________________



Please upload your letter of intent (required).



Section 3 - Declaration and Consent

_________________________________________

I am aware that the mandatory documents listed below are required to be assessed by the Scholarship Selection Committee, and have fully completed this application form including the letter of intent.

By checking off the box below, I confirm that -
- As the legal representative of ; submitting this application, I affirm that I have the authority to sign a legally binding agreement.
- The applicant will attend the program as consistently as his/her health and circumstances allow.
- I certify that all of the information I have submitted is true, correct, accurate and valid.


Parent/Guardian #1 Full Legal Name: Date:
I confirm the conditions outlined in Section 3


Parent/Guardian #2 Full Legal Name: Date:
I confirm the conditions outlined in Section 3


KEEP IN TOUCH

Address:
Bay 12, 6325 – 12 St SE
(North of Deerfoot Meadows near Costco and Ikea)

 Phone:
403 452 7600

Email:
dubasovdw@gmail.com

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