Scholarship Please tick off which scholarships you are interested in applying for that will be available in the fall of 2020. Copnick/Hilliard Scholarship Sun Life Financial Peer Support Scholarship Kirby Rowe Scholarship Scholarships * The Chopnick Hilliard Scholarship is open to any post-secondary student who has a spinal cord injury and who is living in Canada. There is one scholarship worth $1,500.The Sun Life Financial Scholarship is open to any post-secondary student with a spinal cord injury who is living in Canada, and who is also a peer support volunteer with one of SCI/CPA corporate members. To be eligible, the applicant will need a letter of support from his/her corporate member stating that he/she is a peer support volunteer. There is one scholarship worth $1,500.The Kirby Rowe Scholarship is established in memory of William Kirby Rowe who provided outstanding and valued leadership throughout his career to advance access and inclusion for people with disabilities in Canada. One Kirby Rowe Scholarship of $1,000 is available annually to a student with a spinal cord injury to pursue post-secondary education in fields related to management and leadership. Prior to submitting an application, candidates are asked to learn more about the illustrious career of Kirby Rowe by reading his short biography at: https://sci-can.ca/about-kirby-rowe. Applicants are required to submit a letter addressing the following items: Applicant personal history and leadership experience to date; career aspirations as a leader; identification of an inspirational leader, and as well, highlight the qualities of that leader the applicant aspires to develop.DEADLINE: MAY 31, 2020 at midnight.Applicants must meet all of the following criterial to be eligible.The applicant must be a Canadian citizen or landed immigrant.The applicant must be attending, or will be attending, a recognized post-secondary institution in Canada.The applicant has provided a copy of his/her most recent two years of transcripts (unless the applicant has not been in school for the past five years).One letter of reference is required, recognizing the applicant’s outstanding initiative, scholastic achievement and contributions to the community.For the Sun Life Financial Peer Support Scholarship, the applicant must be engaged as a peer volunteer with one of the SCI Canada Federation Corporate Members and MUST provide a letter of support from the organization. Personal Information Name Prefix - None -Mrs.Ms.Mr.Dr. First Name * Middle Name Last Name * Birth Date * Year19201921192219231924192519261927192819291930193119321933193419351936193719381939194019411942194319441945194619471948194919501951195219531954195519561957195819591960196119621963196419651966196719681969197019711972197319741975197619771978197919801981198219831984198519861987198819891990199119921993199419951996199719981999200020012002200320042005200620072008200920102011201220132014201520162017201820192020 Year MonthJanFebMarAprMayJunJulAugSepOctNovDec Month Day12345678910111213141516171819202122232425262728293031 Day Street Address * City * Postal Code * Country * AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Saint Eustatius, and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongo, Republic of theCongo, The Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d’IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland Islands (Malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly See (Vatican City State)HondurasHong KongHungaryIcelandIndiaIndonesiaIran, Islamic Republic ofIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKosovoKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesia, Federated States ofMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarReunionRomaniaRussian FederationRwandaSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSerbia and MontenegroSeychellesSierra LeoneSingaporeSint Maarten (Dutch Part)SlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyrian Arab RepublicTaiwanTajikistanTanzania, United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUnited States Minor Outlying IslandsUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands State/Province * Phone Number * Mobile Phone Number Email * Educational Information What is your career goal? * Name and address of the school you will be attending this year * Starting Date of Program * Year20182019202020212022 Year MonthJanFebMarAprMayJunJulAugSepOctNovDec Month Day12345678910111213141516171819202122232425262728293031 Day Anticipated completion date of program * Year2018201920202021202220232024202520262027202820292030 Year MonthJanFebMarAprMayJunJulAugSepOctNovDec Month Day12345678910111213141516171819202122232425262728293031 Day What courses are you planning to take in each semester this school year? Fall * Winter * Spring/Summer * Have you ever not completed an educational program you began? * Yes No If yes, please provide details * Financial Information Are you receiving a scholarship or bursary this coming school year from any other source? * Yes No If yes, what is the amount? Are you eligible for Employment Insurance Reachback Funds? * (For instance, if you collected EI benefits in the last 3 years, you might be eligible. You can contact your local Human Resources Development Canada office for more information) Yes No Don't know Have you been approved for a Canada Student Grant? * Yes No Please explain why you need this scholarship and how it will help you pursue your career goal * What is your annual tuition cost? * Have you ever received a scholarship from SCI Canada before? * Yes No If yes, which scholarship did you receive, what was the$ amount and when? * References Please provide one reference letter. The letter should address the applicant’s outstanding initiative, scholastic achievement and potential contributions to their community. Peer Support Letter Only needed for the SunLife Financial Applications. More informationFiles must be less than 2 MB. Allowed file types: gif jpg jpeg png pdf doc docx. Upload Reference Letter More informationFiles must be less than 2 MB. Allowed file types: gif jpg jpeg png pdf doc docx. Upload Transcript More informationFiles must be less than 2 MB. Allowed file types: gif jpg jpeg png pdf doc docx. Upload By signing this document, I am stating that to the best of my knowledge, the above answers are correct and complete. I hereby authorize Spinal Cord Injury Canada to verify information that I have provided in this application with organizations such as educational institutions and funding agencies. I understand that false or complete information will result in automatic disqualification of my application. Date * Year20182019202020212022 Year MonthJanFebMarAprMayJunJulAugSepOctNovDec Month Day12345678910111213141516171819202122232425262728293031 Day Full Name * Confirmation * Please confirm the following... I am an individual with a spinal cord injury. I am a Canadian citizen or landed immigrant. I have submitted all required documents (Any hard copy documents please send to: Spinal Cord Injury Canada, 477 Mt. Pleasant Rd, Suite 105, Toronto, ON, M4S 2L9) Consent To help promote our scholarship program, it would be helpful to share information about our scholarship recipients. If I am awarded a scholarship, I give consent to SCI Canada to share my photo and bio on its website Submit
