Scholarship Application

Eligibility Requirements

Enrolled/enrolling in Automotive Technical Trade Apprenticeship Programs. (Apprenticeship awards only)
Enrolled/enrolling in Canadian Automotive Institute Program (either Georgia College, Barrie, or SAIT Polytechnic, Calgary)
Alberta Resident
Employed by an active MDA member dealer (apprenticeship awards only)
Financial need

Personal Data
Name

Prefix

First

Last
Address

Street Address

City

Province

Postal Code
Home Phone
Cell Phone
Email
Untitled
Date of Birth

Date Format: MM slash DD slash YYYY
Student ID Number
Social Insurance Number
Educational Data
Date of High School Graduation

Date Format: MM slash DD slash YYYY
Post Secondary Education
Year
Faculty
Institution
Academic Achievements
Transcripts Upload
Drop files here or
Please Ensure Copies of the following Documents Are Included with Your Completed Application Form (required for consideration):
1. Transcript from your previous year’s training (if entering first year, high school transcripts are required)
2. Enrollment Letter From the Institution (ie: NAIT, SAIT, RDC, etc) confirming that you are enrolled for upcoming or current training.
3. Student ID Number
Transcript of marks MUST be attached with application each time a scholarship is applied for

NOTE: Documentation to verify enrollment and acceptance in either the C.A.I. or an Automotive Technical Program MUST be provided with this application

Documents must be in pdf, doc, or docx format and no more than 2MB
Work Experience

CURRENT EMPLOYER
Current Employer Name
Address

Street Address

Address Line 2

City

State / Province / Region

ZIP / Postal Code

Country
Years
Occupation
PREVIOUS EMPLOYER
Previous Employer Name
Address

Street Address

Address Line 2

City

State / Province / Region

ZIP / Postal Code

Country
Years
Occupation
Financial Data

A) To be answered by INDEPENDENT students. An independent student is one of the following
- Married, or
- Has been employed for three years
Period of Employment for last 12 months
Gross Earnings
Financial Assistance Details
Give details of any financial assistance you will receive for the coming year (i.e. loans, scholarships, bursaries, etc.)
B) o be answered by all DEPENDENT students. A dependent student does not have the criteria for independence
Are you presently residing with the chief wage earner?
- Yes
- No
Occupation of chief wage earner in your family?
Gross Annual Income
Relationship to you
Number of other persons dependent on him/her
Family Members Attending a Post Secondary Institution
If any other members of family are attending a post secondary institution, provide name, age, faculty, year and institution:
C) to be answered by MARRIED students.
Savings on hand beginning of session
Expected part time earnings during school term
Contribution from parents or spouse
Other Income (tax rebates, etc.)
Scholarships/Bursaries already granted
TOTAL RECEIPTS
EXPENSES
Tuition and Fees
Books and Supplies
Estimated living costs (rent, food, clothing, etc.)
Babysitting (actual cost)
Other (explain(
TOTAL EXPENSES
Reasons for Financial Assistance
Briefly state your reasons for indicating a need for financial assistance including any extenuating circumstances
References

Reference 1
Name

First

Last
Phone
Relationship
Reference 2
Name

First

Last
Phone
Relationship

Eligibility Requirements

Scholarship Application

Personal Data

Educational Data

Post Secondary Education

Work Experience

CURRENT EMPLOYER

PREVIOUS EMPLOYER

Financial Data

EXPENSES

References

Reference 1

Reference 2