Apply for the Osum Spark Award

Personal and Contact Information
Your Name*
Current Address*
Street Address City Province Postal Code
Membership in which Indigenous Community*
Date of Birth*
Required Consent*
- I am over 17
- I agree to provide signed consent from my parent or legal guardian when requested
Phone*
(###)###-####
Email*

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Academic Information
Name of institution you'll be attending*
Name of your program of study*
Length of program
Start Date (MMYY)*
End Date (MMYY)*
Confirmation of Full-Time Studies*
- Yes, I confirm that I plan to attend an accredited post-secondary institution or pursue an apprenticeship program on a full-time basis

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Biographical Information
Help us get to know you by answering the following required questions:
Tell us about the place, or places, you call home.*
They can be physical places where you have lived, or a community or group that is important to you.
Why have you chosen your particular field of study?*
Describe how you have taken advantage of a significant educational opportunity or worked to overcome an educational barrier you have faced.*
Tell us about one of your extracurricular activities or work experiences that was particularly meaningful to you – and why?*
What are your plans after you graduate from post-secondary? How will you use your education to create positive impact in the community?*
What is one thing that we don’t know about you that you want us to know?*

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Reference Information
*Reference forms will be submitted separately online, by fax or email. Reference forms will be accepted at any time up to the application deadline of Midnight MST on Friday, May 24, 2019.

- References should not be a friend or relative
- Please provide one academic and one character reference
Name of Reference 1*
Reference 1 Phone*
Reference 1 Email*
Please provide an email address for your reference if possible. We'll send them an automatic notification that you've applied for a Spark Award, along with a link to the Reference Form.
Name of Reference 2*
Reference 2 Phone*
Reference 2 Email*
Please provide an email address for your reference if possible. We'll send them an automatic notification that you've applied for a Spark Award, along with a link to the Reference Form.
How did you hear about the Osum Spark Award? (Please choose one)*
- Facebook
- Instagram
- Postcard/Poster
- A friend or family member
- Through my student association

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Declaration and Consent
To proceed with your application, you must read and consent to the direct and indirect collection of your personal information, the use and disclosure of your personal information, as well as the terms and conditions set out below. Applicants under the age of 18 must also obtain the consent of their parent/guardian.
I agree that:*
- I meet the eligibility criteria
- I have given complete and true information on this form
- I am responsible for updating Osum with my personal information. I will promptly notify Osum of any change to information that I have provided in my application, including changes to academic, period of study status and/or contact information. I will communicate these changes by email to community@osumcorp.com
- I understand that I am responsible for providing all required supporting documentation as indicated on my application
- I understand that the information I provide may be verified by Osum and I give my consent to both my educational institution and Osum to confirm such information
- I am over 17 years of age OR I am under 18 years of age and am providing a guardian signature for approval.
- I give my consent to Osum to use, publish my name, photo and relevant information for publicity and promotional purposes
Consent*
- I have read and give my consent to the indirect collection and disclosure of my personal information and also understand and agree to the terms and conditions as outlined above.
Type Your Full Name*
Date*
The date you completed this application
Comments
This field is for validation purposes and should be left unchanged.

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Step 1 of 5 - CONTACT INFO

Personal and Contact Information

Academic Information

Biographical Information

Reference Information

Declaration and Consent