2017 Scholarships

Jess Daniel Nichol Memorial Award

Application Form

Deadlines for submission: October 16, 2017

Submit application to the VCC Foundation

The Jess Daniel Nichol Memorial Award is offered to students entering the Music program at Vancouver Community
College who have a strong interest in music and have encountered challenges in their lives. Preference will be given to
residents of the Downtown Eastside area of Vancouver and those who have a financial need.
Scholarship value: $3,000 ($1,500/ year x 2 years)

Personal Information:
Wetmore
_______________________________________________ ______________________________________________
Last Name First Name(s)

_______________________________________________ ______________________________________________
Social Insurance Number VCC Student Number

_____________________________________________________________________________________________________
Apt # Street Address City Postal Code

___________________________ __________________________ _________________________

Telephone E-Mail Date of Birth (dd/mm/yyyy)

Program Information:
Fashion Design
_______________________________________________ _____________________________________________
Name of your program(s) Date of Completion
Fashion Design
_______________________________________________ _____________________________________________
Name of your program(s) Date of Completion

Please describe briefly how you meet the criteria:

(Use additional sheets as required)

Declaration:
I hereby declare that the information contained in this application is correct and complete. I agree that if I receive the Jess Daniel
Nichol Memorial Award, VCC may publish my photograph, name, program name, home municipality and high school (if
applicable). Submit your complete scholarship application by the deadline date of October 16, 2017 to the following address:

Vancouver Community College Foundation

1155 East Broadway
Vancouver, B.C. V5T 4V5
Signature of Applicant
 2017 Scholarships
Jess Daniel Nichol Memorial Award
Application Form

Living Arrangements:

v p

student living with parents student - living alone

p Dv law no children

p number of children living with you: Their age(s):

law with children - number of children living with you: __ Their age(s):

Financial Information:

I have received: Student Loan/Grant $

I have not applied for the above because: _______________________________________________________

Income source Student (monthly) Spouse (monthly) Total

Employment
Contributions from parents
Savings
Child tax benefit
Child support
Student loans/Government funding
Other income (specify)
EI/IA sponsorship for tuition, supplies
and books
EI/IA sponsorship for living expenses N/A
Total monthly income $ N/A

Expenses Student (monthly) Spouse (monthly) Total

Daycare
Living expenses: rent/mortgage
Living expenses: utilities
Living expenses: food
Other expenses (specify)
Total monthly expenses $ N/A

I certify that the above information is complete and correct. I give the Financial Aid Department permission to release any of this
information to a donor.

______________________________________ ______________________________________
Applicants signature Date