CANADIAN MINERAL INDUSTRY EDUCATION FOUNDATION MINING INDUSTRY SCHOLARSHIPS Geology - Mining - Metallurgy - Engineering The Canadian Mineral Industry Education Foundation is supported by most of the principal mining companies in Canada with the objective of offering scholarships to students attending Canadian universities who have a genuine interest in being employed in the mining industry. Scholarships are awarded in April to students who will be attending university in September 2017. Eligibility To be eligible, applicants must meet the following requirements: 1. Be a Canadian citizen or landed immigrant in Canada. 2. Have successfully qualified to enter in September the second, third or fourth year of a degree course in disciplines related to the mining industry at a Canadian university as a full-time student. To Apply 1. 2. Complete this application form in full. If more space is required, attach separate sheets. Forward the completed form, along with official transcripts of academic record or an unofficial transcript signed and dated by the Registrar, and a letter outlining your career aims and objectives to: (Please do NOT staple documents and please print clearly.) Jacqueline Blair, Secretary Canadian Mineral Industry Education Foundation P.O. Box 459 31 Adelaide Street East Toronto, ON M5C 2J5 Tel: 416 869 0772 Fax: 416 367 3638 email: [email protected] www.cmief.ca PLEASE NOTE The deadline for submission of applications is March 31, 2017. APPLICATIONS RECEIVED AFTER MARCH 31 WILL NOT BE CONSIDERED. The selection of scholarship awards will normally be based on the information received. Applications may be supported by other documents in addition to those requested such as a résumé, reference letters, publications, or any other items you feel are appropriate. Ensure that your application is complete and that you forward all the necessary documentation. INCOMPLETE APPLICATIONS WILL NOT BE CONSIDERED. Applicants will be notified in May of the status of their application. SURNAME: ________________________ FIRST _________________________ PRESENT ADDRESS: ___________________________________________________ ___________________________________________________ ___________________________________________________ TELEPHONE NUMBER: ____________________ email: _______________________ PERMANENT ADDRESS: ________________________________________________ (if different from above) ________________________________________________ ________________________________________________ ARE YOU A CANADIAN CITIZEN? YES _____ NO _____ ARE YOU A LANDED IMMIGRANT? YES _____ NO _____ SOCIAL INSURANCE NUMBER: __________________ DATE OF BIRTH: YEAR __________ MONTH _________ DAY _________ PREVIOUS EDUCATION (detail your previous secondary, trade, technical, college or university education) Institution Name Course of Study Years Attended From - To Graduated? Yes or No Diploma/Degree Obtained CURRENT EDUCATION: UNIVERSITY: _____________________________ DATE OF GRADUATION: YEAR _______________ COURSE OF STUDY (check one) Geology Geological Engineering Mining Engineering Mining - Mechanical ______ ______ ______ ______ MONTH _______________ Mineral Processing Metallurgy ______ ______ SCHEDULE: Record below your programme through to graduation, as to when you will be at university and when you will be on a work term: 2017 MayAug SeptDec 2018 JanApr MayAug 2019 SeptDec JanApr MayAug 2020 SeptDec JanApr e.g. Work (W) or Academic (A) OTHER SCHOLARSHIPS RECEIVED __________________________________________________________________________ __________________________________________________________________________ 2 EMPLOYMENT (attach to this application details of your previous summer, part-time, or fulltime employment or a résumé) OTHER ACTIVITIES OR INTERESTS ___________________________________________________________________________ _ ___________________________________________________________________________ _ ___________________________________________________________________________ _ PLEASE READ BEFORE SIGNING All of the information on this application and any attached documents are accurate and truthful. ___________________ _____________________________________ Date Signature of Applicant 3 EMPLOYMENT (detail your previous summer, part-time, or full-time employment) Name and address of employer Work description and responsibilities Dates to/from Type of employment (summer, part-time etc.)
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