Peter Corley Memorial Scholarship
Application Form

NAME:           __________________________________________
ADDRESS:        ___________________________________
City:           ________________ Prov:___________
Postal Code:    __________
Tel:            ________________________
E-Mail address: ______________

Date of birth :_______________ S.A.C. member since______
Have you flown a glider solo in the last 12 Months?_________

Have you been awarded this scholarship previously?________
			    If yes, indicate when?________

If you are not currently attending a post-secondary educational institution, have you been accepted for attendance?_________

Name of the post-secondary educational institution you are attending, or planning to attend:

Name of the degree sought:_______________________________
Year of expected graduation:_______
Field of studies? (engineering, sciences,  languages, etc)______________________


What club are you a member of?__________________________
Member since?______________		
						
Which most accurately describes your situation? ___________
(See list below and enter corresponding letter above)

A- I will be attending a community college.
B- I will be in my freshman year at university.
C- I will be in a second year of an undergraduate program leading to a    degree.
D- I will be in a third year of an undergraduate program leading to a degree.
E- I will be in a fourth year of an undergraduate program leading to a    degree.
F- I will be undertaking post-graduate studies.


Briefly describe your academic and career  objectives:





             (use an additional sheet if necessary)

Signed:_____________________________    Date:__________


____________________________________________________________________________

SOARING ASSOCIATION OF CANADA
ASSOCIATION CANADIENNE DE VOL À VOILE
Suite 107, 1025 Richmond rd,  
Ottawa, Ontario K2B 8G8     
tel: (613) 829-0536      
fax: (613) 829-9497     
email: sac@sac.ca