2021 Kelman Scholarship
6559A Mississauga Road, Unit C, Mississauga, ON L5N 1A6
T: (416) 410-6933
W: www.weao.org E: scholarship@weaocommittee.org
Updated April 30, 2021 Page 1 of 3
APPLICATION FORM
APPLICANT INFORMATION
( ) -
Name
Phone
Street Address
City, Province, Postal Code
Email Address
ACADEMIC INFORMATION
High School
Street Address
City, Province, Postal Code
Grade
REFERENCES
Your referee must complete the Reference Form and submit directly to WEAO by email
scholarship@weaocommittee.org. Ensure they send it by the submission deadline to the Attention of:
Kelman Scholarship 2021”.
Teacher’s Name
Subject(s)
School
2021 Kelman Scholarship
6559A Mississauga Road, Unit C, Mississauga, ON L5N 1A6
T: (416) 410-6933
W: www.weao.org E: scholarship@weaocommittee.org
Updated April 30, 2021 Page 2 of 3
HOW DID YOU LEARN OF THE KELMAN SCHOLARSHIP? (Check all that apply)
WEAO website
Scholarship website: please state which one:
My school’s Guidance Councilor/Resource Teacher
Other:
DECLARATION
I, (full name) , certify the information provided to be true and
complete and authorize the release of the information to the WEAO Scholarship Committee for review. I
authorize that my name, photograph, and general information about me can be used for promotional
purposes in WEAO communications materials, should I receive this scholarship.
Date:
Note: Electronic submission of an application from an applicant's email address constitutes an electronic
signature and confirms agreement with the requirements of the scholarship. Identities of winning applicants
may be further verified upon award of the scholarships.
Application Deadline: August 13, 2021
Submit your completed application as a single PDF file by email to
scholarship@weaocommittee.org
2021 Kelman Scholarship
6559A Mississauga Road, Unit C, Mississauga, ON L5N 1A6
T: (416) 410-6933
W: www.weao.org E: scholarship@weaocommittee.org
Updated April 30, 2021 Page 3 of 3
APPLICATION ESSAY
Name:
Start Essay text here: