Ontario Professional Fire Fighters Association

WAYNE DEMILLE SCHOLARSHIP APPLICATION FORM

OPFFA MEMBER INFORMATION

MEMBER LOCAL # *

MEMBER LOCAL NAME *

LOCAL PRESIDENT NAME *

MEMBER FIRST NAME *

MEMBER LAST NAME *

RELATIONSHIP TO APPLICANT: *

MEMBER ADDRESS *

ADDRESS 2

CITY *

PROVINCE *

POSTAL CODE *

APPLICANT/STUDENT INFORMATION

APPLICANT FIRST NAME *

APPLICANT LAST NAME *

APPLICANT EMAIL *

APPLICANT PHONE *

SECONDARY SCHOOL INFORMATION

SECONDARY SCHOOL NAME: *

SECONDARY SCHOOL CONTACT NAME:

SECONDARY SCHOOL PHONE NUMBER

SECONDARY SCHOOL ADDRESS

ADDRESS 2

CITY

PROVINCE

POSTAL CODE

POST-SECONDARY SCHOOL INFORMATION

POST-SECONDARY SCHOOL NAME *

PROGRAM ENROLED IN *

POST SECONDARY SCHOOL ADDRESS

ADDRESS 2

CITY

PROVINCE

POSTAL CODE

TRANSCRIPT UPLOAD *

Please upload your most recent transcript whether it is a copy of your high school (grade 12) or the last year completed at a post secondary institution.

REFERENCE LETTER *

Provide at least one letter of reference from a community contact, school official, and/or employer.

STATEMENT OF COMMUNITY ACTIVITIES *

In 200 words or less, please briefly describe your school, community, and home life involvement activities that demonstrate your commitment to your broader community.

CODE OF ETHICS *

In 200 words or less explain how you believe your success in a post-secondary education program will help you strive to exemplify the OPFFA’s “Code of Ethics”.

PROOF OF ENROLMENT *

Provide upload proof of enrolment in a Post-Secondary Institution.

* Required Fields

Tweets