William A. Laird Memorial Scholarship Application 2015

 Name______________________________________________            First Application  (Yes or No)  ______

                   First Name                                    Initial                           Last Name

Address_______________________________________ City______________ Postal Code__________

Home phone    (____) ______________

Name of qualified parent________________________________

 

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 of Academic Institution_______________________________________ City______________  Postal Code_________

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

Address of Academic Institution_______________________________________ 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.   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:

Post-Traumatic Stress Disorder is becoming a growing concern for fire fighters and other emergency responders.  The Provincial Government is providing Presumptive Legislation that will make PTSD a recognized condition under Workers compensation.  Discuss how this will impact and improve the lives of fire fighters and their families.

____________________________                  _______________________                                        ___________________________

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 20, 2015.

(Late entries will NOT be accepted.)