Student Application for Community Service Bursary | eServices Prince Edward Island

Current Page 1
Preview

Personal information on this form is collected under subsection 32(2) of the Prince Edward Island's Freedom of Information and Protection of Privacy Act R.S.P.E.I. 1988 c.F-15.01 and will be used for the purpose of programs under Student Financial Services and with any other provincial department as may be necessary to evaluate the submission. If you have any questions about this collection of personal information, you may contact Student Financial Services: PO Box 2000, 176 Great George Street, Suite 212, Charlottetown, PE, C1A 7N8, 902-368-4604.

Identification

First Name

Middle Initial

Last Name

Address 1

Address 2

City, Town, or Community

Province

Postal Code

For example C1B 0X1 or 12345

Country

Telephone Number

For example 902-555-5555

Email Address

Please do not use your high school (.edu) email because this email expires after you graduate from high school. Our office will continue to contact you for more information until the bursary is awarded in November.

Residency Status

Parent/Guardian

Parent/Guardian's Telephone Number

For example 902-555-5555

High School Information

High School

Other School

Current Grade

Expected Graduation Year

Acceptance

I confirm that all information on this application is true to the best of my knowledge, and I understand that providing false or misleading information on this form will result in the disqualification of my application. Any educational institution I have or am attending may provide any information about my academic standing, attendance, awards, accommodations, and financial status to Student Financial Services. This authorization provides complete authority to collect, use, retain and disclose personal information to the extent reasonably necessary in connection with my application under, and my participation in, the Community Service Bursary.

CAPTCHA