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

Please note that any fields that include "*" are mandatory.
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) INDEPENDENT students:

Married, or Has been employed for three years.
Married*
- YES
- NO
Employed for 3 years*
- YES
- NO
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) DEPENDENT students:
To be answered by all DEPENDENT students. A dependent student does not have the criteria for independence
- You do 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*
If there are no other persons dependent on them please enter "0"
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) MARRIED students:
To be answered by MARRIED students.
- You are married.
Savings on hand beginning of session*
Expected part time earnings during school term*
If no expected earnings please enter "0".
Contribution from parents or spouse*
If there were no contributions please enter "0".
Other Income (tax rebates, etc.)*
Scholarships/Bursaries already granted*
If you have not received any scholarships or bursaries please enter "0".
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

A) INDEPENDENT students:

EXPENSES

References

Reference 1

Reference 2