Johnson Incorporated Bursaries Application Form

Applications must be received at the NLTA Office by April 1

To be eligible, an individual must be an active member of the NLTA as described by section 1:A.1 of the NLTA policy.

Regulations Governing the Awarding of Johnson Incorporated Bursaries

A sum of $2,000.00 will be made available to the NLTA to be awarded annually to teachers in full-time attendance at university. The value of the awards will depend on the number of awards granted annually by the Professional Issues Committee (e.g. two @ $1,000.00, four @ $500.00).
Where there are competing applicants, on an annual basis, any member may be granted only one award for those programs which are designated for teachers undertaking full-time study.
The bursaries shall be open to both graduate and undergraduate students.
Bursaries will be paid when the successful applicant has notified the Professional Development Division of official registration.
Applications for bursaries must be completed on the form provided.
Applications must be received at the NLTA Office by April 1.
Bursaries awarded are to be used for study undertaken in the Spring, Summer, Fall and Winter semesters following this deadline.

PERSONAL INFORMATION

Name of Applicant: *

Email Address: *

Street Address or P O Box:

Community: *

Postal Code: *

Home Phone Number: *

BURSARY INFORMATION

Indicate Which Semester You Are Registering For: *

Fall

Winter

Spring

Summer

Have You Been Awarded Other Grants, Scholarships, Bursaries?: *

Yes

If YES, indicate award and amount below.

Award and Amount:

What Program of Study Do You Intend To Pursue?: *

Educational Institution You Plan To Attend: *

Have You Been Accepted for this Program of Studies for the Semester(s) Indicated?: *

Yes

If YES, mail a copy of the confirmation of acceptance from the educational institution.

If So, When?:

List Previous Scholarships, Grants, Bursaries, Awards or Honours You Have Received:

Give dates and particulars

ACADEMIC RECORD

1. Degree / Diploma: *

1. Major Field of Study: *

1. Date Conferred: *

2. Degree / Diploma:

2. Major Field of Study:

2. Date Conferred:

3. Degree / Diploma:

3. Major Field of Study:

3. Date Conferred:

Number of Years Teaching

In the Province:

Elsewhere:

Name of School: *

Street Address or P O Box of School:

Community of School: *

Name of School District: *

Address of School District: *

Current Teaching Assignment: *

Briefly Describe Educational Experience:

(School(s) Grades Taught)

List Involvement(s) with NLTA, school, district, community:

Provide Any Other Information Which You Think May Be Helpful to the Selection Committee:

May 2012

S	M	T	W	T	F	S
		1	2	3	4	5
6	7	8	9	10	11	12
13	14	15	16	17	18	19
20	21	22	23	24	25	26
27	28	29	30	31

2012
Jan  Feb  Mar  Apr  May  Jun
Jul  Aug  Sep  Oct  Nov  Dec

2013
Jan  Feb  Mar  Apr  May  Jun
Jul  Aug  Sep  Oct  Nov  Dec