Name_________________________________________  First Application  (Yes or No)  ______

First Name                                    Initial                           Last Name

 

Address_______________________________________ City______________ Postal Code__________

 

Home phone (____) ______________ Name of qualified parent________________________________

Area code

 

Status of Parent: (Circle one)  Active   Retired   Disabled  Deceased    Personal I.A.F.F. #________________

 

How many in family________  Name of Parents_____________________________________________

 

List names and dates of birth of siblings:

_________________­­_____________    _________________________________

 

______________________________    _________________________________

 

Academic Institution presently attending_______________________________ Year in school _______

 

Address_______________________________________ City______________  Postal Code_________

 

Post Secondary Institution you will be attending in 2014-15 __________________________________

 

Address_______________________________________ City______________ Postal Code__________

 

OR

 

Fire College at which you completed NFPA Fire Fighter Level II _______________________________

 

Address_______________________________________ City______________ Postal Code__________

 

Please indicate how you anticipate covering your costs throughout the next school year or how you covered your costs to attend Fire College, i.e. part time work, family assistance and other scholarships or awards applied for or received.

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

ALONG WITH THIS COMPLETED APPLICATION FORM PLEASE SUBMIT THE FOLLOWING ON SEPARATE PAGES

1. 1.              Please indicate how you are involved in your community.  Bill Laird embodied Community    Service, and therefore this section will merit considerable recognition.
2.   A transcript of your marks.
3. A typed essay (not less than 1000 words) ON THE FOLLOWING TOPIC:

 

The nature of modern building construction has changed dramatically over the last few decades.  Discuss the hazards of new building construction (including construction materials and furnishings).  How is this affecting the health and safety of fire fighters?

 

 

 

 

____________________________       _______________________     ___________________________             Date of Application                                                                   Signature of Parent                                                    Signature of Applicant

 

RETURN COMPLETED APPLICATION TO:

United Fire Fighters of Winnipeg, 303-83 Garry Street, Winnipeg, Manitoba R3C 4J9

Attention: W.A. Laird Scholarship Committee. Fax 204-772-2531

This application must be returned to UFFW by, or postmarked on or before July 15, 2014. (Late entries will NOT be accepted.)