Husky Energy Scholarship Application Form
Husky Energy Scholarship Application Form
Husky Energy Scholarship Application Form
Applicant Information
First Name:
Last Name:
Prefix:
Permanent Address:
City:
Province / State:
Country:
Telephone:
Email:
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Scholarship Program for Indigenous Students
2018 Application Form
Academic
Scholastic History
Please list the educational institutions attended during the last two academic years.
Post-Secondary Data
List the name of the educational institution you plan to attend during the upcoming academic year.
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Scholarship Program for Indigenous Students
2018 Application Form
Additional Information
Essays
Please provide a short essay describing your community involvement over the past five years.
* Financial Need
Please describe your personal and family financial circumstances (family employment, economic situation, etc.), and the financial needs
you will face while attending university or college.
* Essay
Please describe your interest and/or future plans in the Oil and Gas Industry. How this scholarship would assist in meeting your career
goals.
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Scholarship Program for Indigenous Students
2018 Application Form
In compliance with Privacy Law, information about your application will not be released to anyone who has not been specifically
authorized by you, the applicant. Third parties (parents, guardians, etc.) may contact Universities Canada on your behalf, in person,
by phone, or by email, to receive information about your application but only if you have authorized them on your account.
To add an individual to your file, please provide the names of family members or legal guardians to whom Universities Canada may
release your personal information. Please also provide a verbal password for their use when contacting Universities Canada.
Information about your file will be only be given to those individuals who appear on your list and can provide this password. It is your
responsibility to ensure the parties named below are aware of the password you have provided Universities Canada.
Note: You are not required to provide access to your file and may change the information at any time.
First Name:
Last Name:
Password:
First Name:
Last Name:
Password:
Supporting Documentation
As part of this application, the supporting documentation described below is required. If any of these documents are not received and
accepted, your application will be considered incomplete and will not be evaluated. Supporting documents must be received by Universities
Canada on or before 2018-06-15.
Documents may be uploaded through submitting an online application or sent directly to the address below.
Letters of Reference
All letters must be dated, typewritten on letterhead, signed with an original non-electronic signature and include the
reference’s contact information. If possible, the person writing the letter of reference should describe their relationship to
the applicant in the letter. Reference letters must be written in the year of application.
One letter of reference is required to support your application and must come from an individual who is not related to the ap plicant. The
letter must come from a person who is familiar with your volunteer, community involvement and/or extracurricular activities.
To assist you in the preparation of this letter, please refer to the instructions for referees.
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Scholarship Program for Indigenous Students
2018 Application Form
Transcript
Please provide an official transcript of the last 2 terms of available marks. A transcript will be only considered acceptable if it is presented on
the official paper of the institution AND it bears the appropriate signature(s) and/or seal of the institution. Home school g rades will only be
accepted if they have been validated through a recognized, independent evaluation process.
Transcripts may be uploaded to the online application, however an original copy may be requested at any time, in order to verify its
authenticity.
Husky Energy has contracted with Universities Canada for the administration of their scholarship program. This administration role
includes the application process, the evaluation and selection process, the processing of recipients' files and the administering of
payments for the scholarship on behalf of Husky Energy. The purpose of this statement is to set out Universities Canada's
commitment to the protection of personal information collected, used, disclosed or retained in performing this function. Universities
Canada will comply with the requirements of the Canadian Personal Information Protection and Electronic Documents Act (PIPEDA)
for the collection, use, disclosure and retention of personal information provided by you in the course of your scholarship
application.
Universities Canada has appointed a Privacy Officer with overall responsibility for Universities Canada privacy compliance. Should
you have any questions, concerns or complaints regarding the privacy of your personal information please contact the Privacy
Officer by calling (613) 563-1236 or by writing to: Privacy Officer at 1710-350 Albert Street, Ottawa, ON K1R 1B1.
Please find below a summary of Universities Canada's privacy policies concerning the collection, use, disclosure and retention of
the personal information you will be submitting in this application. Please read the information below carefully as by submitting your
application you are consenting to the collection, use, disclosure and retention of your personal information as summarized below. A
full version of Universities Canada Privacy Code which outlines Universities Canada's complete personal information management
practices, policies and procedures is available on line at www.univcan.ca or by requesting a copy from Universities Canada Privacy
Officer.
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Scholarship Program for Indigenous Students
2018 Application Form
CONSENT
You may refuse to provide personal information to us. You may also withdraw your consent at any time, subject to legal or
contractual restrictions and reasonable notice. However, in either case, this may limit your scholarship eligibility and our ability to
administer the scholarship payments. By completing and signing [submitting] this application you are consenting to the collection,
use, disclosure and retention of your personal information for the above stated purposes.
I have read and agree with the above consent. I have also read the scholarship guidelines and understand the eligibility
requirements for this program. I certify that all information provided in this application form and attached documents are
true and accurate to the best of my knowledge. I understand that acceptance of this application or receipt of any
scholarship/award issued to me may be revoked without notice if any information in this application is subsequently found
to be false.
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