In memory of bro. Vincent steeves

“D.L.WOOD SCHOLARSHIP”

IN MEMORY OF BRO. VINCENT STEEVES

1. 
   The value of the scholarship is $1000.00.
   

2. 
   Completed applications must be sent to:
   

Keith Lodge Scholarship Chairman,

78 Ammon Road,

Moncton, NB, E1G 2K4

and postmarked no later than May 31^st application year.

3. 
   Application open to any grade twelve student in the Anglophone East or Francophone South School Districts of N.B. planning to enroll in a recognized university or college in Atlantic Canada within 4 months of graduation from high school. Preference will be given to a student having a relative that is/was a member of Keith Lodge #23 in Moncton, N.B., however consideration will be given to those students who have assisted Keith Lodge activities in some way.
   

4. 
   Preference will be to a student pursuing studies in the health sciences, however favorable consideration will be given to all sciences, or other fields with a humanitarian connection.
   

5. 
   Recipient must provide proof of enrollment/attendance at the institution of higher learning before a cheque is issued.
   

“D.L. WOOD SCHOLARSHIP”

IN MEMORY OF BRO. VINCENT STEEVES

(PLEASE PRINT ALL REQUIRED INFORMATION)

FULL NAME: ________________________________________________

MALE: ____ FEMALE: ____

DATE OF BIRTH: DAY: ______ MONTH: ______ YEAR: _______

MAILING ADDRESS: _________________________________________

_________________________________________

_______________________ PC: ______ _______
PHONE: _____________________________________________________
EMAIL: _____________________________________________________
HIGH SCHOOL ATTENDING: _________________________________

HIGH SCHOOL PHONE NUMBER: _____________________________
CONNECTION TO KEITH LODGE #23 AS PER #3 ON INFO PAGE:

UNIVERSITY/COLLEGE: _____________________________________

FIELD OF STUDY: ___________________________________________
TO THIS APPLICATION, PLEASE ATTACH THE FOLLOWING THREE ITEMS:

1. 
   A SINGLE TYPED PAGE TELLING US WHAT WE SHOULD KNOW ABOUT YOU…. ACCOMPLISHMENTS?, EXPERIENCES?, AMBITIONS?, ACCOLADES?, AWARDS?, SKILLS?, AND ANY OTHER TRIVIA WHICH SAYS “WHO YOU ARE!”
   
2. 
   OFFICIAL TRANSCRIPT OF 1^ST /2^ND TERM MARKS.
   
3. 
   PHOTO WITH YOUR NAME ON THE BACK.
   

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