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The Orange Benevolent Society of Saskatchewan
Scholarship Program - Application Form

Name : ___________________________________

Date of Birth: _____________________ Citizenship:______________
Address: _________________________ City:___________________
Province:_________________________ Postal Code:_____________
Email: ___________________________ Phone #:________________
Permanent Mailing address (if different than above):

Name of (Town) High School attended:______________________________________
Educational Institute where currently accepted:

Program enrolled:___________________________________
Current year projected costs: tuition $____________, books, etc. $________ Accommodation (rent) $________________
Start date:_______________________

Please attach the following documents:
- copy of educational transcripts
- proof of enrollment
- proof of student loan acceptance or decline
- resume of employment experience and interests
- essay, outlining plans for future
- proof of necessitation- copy of previous year income tax statement and/or spouses income tax statement if applicable
- two letters of reference

Applicants must be eligible to enroll in and attend a course at an approved Institution with a full course of study.
Scholarship amounts will be determined dependant on applications received and amounts available.
Recipients will be selected on academic achievement, financial need and for those young adults with a plan and dedication for self-improvement as expressed in the required essay. Mature students are encouraged to apply.

Applications must be received at head office by July 31 or December 31 annually. These will be reviewed by our board of directors and those awarded scholarships shall receive their awards prior to October 1, and February 1 of each year. A copy of enrollment approval and/or transcripts from the Institution must be received by OBS prior to awards being released.

Waiver:

I understand that if I am selected as a recipient, I consent to the Orange Benevolent Society of Saskatchewan using photographs or film of myself for the purpose of promoting or publishing the work of the Society. I agree to indemnify the Orange Benevolent Society of Saskatchewan for any claims made against it arising out of the use of such photographs or film.

________________________________________ __________________________________________
Signature of Applicant Date

Mail applications to:
The Orange Benevolent Society
Box 160
Indian Head SK
S0G 2K0
1-877-522-8258 toll free in Saskatchewan
1-306-695-3450
www.obsociety.com