Delta Secondary School

Deadline: April 26, 2023 @ 3pm

Instructions:	Print all information in pen

General Information:

Surname:_________________	Date of Birth:__________________

Given Name (first):_____________________Preferred Name:________________

Email address & cell number:__________________________________________

Post-Secondary Information:

Are you planning to continue your education in September 2023? Yes __ No__

If yes,

Name of Institute:_______________________________________________

Program Name:_________________________________________________

Alternate Post-Secondary Choice:__________________________________

If no,

Will you be attending a post secondary institution within 3 years of graduating?

YES _____ NO ______

Career Goal:

__________________________________________________________

Please list any other awards or scholarships you have been offered/receiving

(for Valedictory purposes):__________________________________________

Grade 11 Final Marks	Grade 12 Final Marks (Gr.12 courses taken in gr. 11 should be put in the gr. 12 column)	Grade 12 Second Semester Interim Marks (if known)	Online Courses Interim/Final marks
Course	Mark %	Course	Final Mark %	Course	Mark %	Course/Mark

Extra-Curricular Activities: Do not include course credit or work experience

School Involvement: Clubs, OrganizationActivities
Year/s (ie. 2016-2023)	Role	Total Hours of Involvement (not per week/year)	Achievements & Most proud of
Team Sports (School and Community)
Year/s (ie. 2016-2023)	Role	Total Hours of Involvement (not per week/year)	Achievements & Most proud of
Volunteer/ Community Participation
Year/s (ie. 2016-2023)	Role	Total Hours of Involvement (not per week/year)	Achievements & Most proud of
Other
Year/s (ie. 2016-2023)	Role	Hours of Involvement (not per week/year)	Achievements & Most proud of

I certify that the information in this application is correct:

Student Signature__________________

YOU MUST BE ATTENDING A POST SECONDARY INSTITUTION WITHIN THREE YEARS OF GRADUATING FROM HIGH SCHOOL TO REDEEM YOUR SCHOLARSHIP/BURSARY

Some Awards list “Being in Financial Need” as part of the criteria. Please indicate on a separate piece of paper the circumstances of your financial need