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    Part A - Personal Information

    *Required Field

    *First name

    *Last name

    *Date of birth

    *Phone number

    *Email

    *Street address (include unit number if applicable)

    *City

    *Postal code

    *Co-op you live in (Must be a COCHF member co-op)

    *Are you a member of your co-op?

    *Are you a director of your co-op?

    *Secondary contact name

    *Relationship

    *Contact Phone Number

    *How did you hear about the scholarship?

    *In September 2022 (please choose what year of university you will be in)

    Part B - Education / Work

    *Enrollment year for September 2022:

    *What program are you enrolled in or plan to enroll in?

    What high school are you graduating or have graduated from?

    *In which year will you graduate or did you graduate?

    What post-secondary institution do you plan to attend?

    If you are already in a college or university program, please provide your student number

    Part C - Volunteer Activities

    Please list the two most recent volunteer activities you have participated in that promote diversity. It is mandatory to list two activities.

    Activity 1

    *Organiztion name

    *What was your role?

    *Hours per week?

    *Start time -

    *End time -

    Please provide a detailed description of each activity, including your responsibilities

    Activity 2

    *Organiztion name

    *What was your role?

    *Hours per week?

    *Start time -

    *End time -

    *Please provide a detailed description of each activity, including your responsibilities

    Diversity

    *Explain how your volunteer activities promote diversity.

    Part D - Essay Question

    Please upload a short essay (500 words) on the following subject:

    The pandemic has worsened the existing gaps between low-income people and the rest of the country. People from diverse backgrounds were particularly impacted.

    What do you think we can do together to even out these gaps as we recover from the pandemic?

    Reading materials that may assist you:

    *Upload file. Must be a PDF file with a maximum size of 2 MB

    Part E - Financial Situation

    Please fill in the chart below with approximate amounts. Include all of your expenses and income sources for the upcoming academic year, not including the Diversity Scholarship. Please remember, you are calculating for the entire year and not just the school year. Misrepresentation of your financial situation will result in your application being disqualified.

    Expenses

    Housing

    Travel (car, public transit)

    Tuition and fees

    Books and supplies

    Personal expenses

    Other


    Total -

    Income

    Personal Savings

    Student loans and grants

    Awards and bursaries

    Family contribution

    Employment income

    Other


    Total -

    Part F - Transcript Upload

    Please attach your transcript as a scanned document (in PDF format - 8MB max)

    Part G - Consent & Declaration

    Test

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