LOCALS 175 & 633
MCKAY-THOMPSON-HOEBINK-GIBSON
SCHOLARSHIP APPLICATION FORM
Applicant Information
First Name:
Last Name:
Email Address:
Permanent Home Address:
City:
Province:
Postal Code:
Telephone:()   - 
I am a member of UFCW Local 175 or 633
I am the of a UFCW Local 175 or 633 member
If applicant is not a member, specify relationship of applicant to member here (i.e. son, daughter or spouse)

UFCW Local 175 or 633 Membership Information
 
Member's First Name:
Member's Family Name:
Member Since:
Employer:
Unit #: (if applicable)

Education Information
 
I will be studying: Full-time Part-time
College/University:
Program of Study:
Starting Date:
This is a year program. I am entering year .
Expected cost of Tuition (pear year) is: $
 
Please submit this as my application form for:

The UFCW Locals 175 & 633: McKay Thompson Hoebink
Gibson Scholarship ($1000)

The UFCW Canada National: The Beggs Dowling Mathieu
Scholarship ($1000)
Upon submitting this application form, I do hereby confirm that the
information submitted herewith is true and complete.
Date: 30-07-2010.