Grand Lodge Bursary Applications
1Prince Edward Island Masonic Bursary
and / or
T. Arthur Dawson Masonic Scholarship
and / or
C. Gordon Lord Masonic Scholarship
Check List: ✍
1. All information requested on the application is complete.
2. The application has been signed by the appropriate Lodge Secretary.
3. A copy or transcript of the Applicant’s marks is included Yes ___ No ____or,
4. A copy or transcript of the Applicant’s marks will be sent by separate mail Yes _ No___.
5. A promotional picture of the Applicant is included that can be used for publicity purposes if the Applicant is successful.
1. APPLICATIONS THAT ARE INCOMPLETE OR NOT SIGNED BY THE APPROPRIATE LODGE SECRETARY MAY NOT BE CONSIDERED FOR THE BURSARY OR SCHOLARSHIPS.
2. ALL APPLICANTS WILL BE CONSIDERED FOR ONLY ONE MASONIC BURSARY, OR T. ARTHUR DAWSON SCHOLARSHIP OR C. GORDON LORD SCHOLARSHIP. ONCE YOU HAVE BEEN ACCEPTED FOR ONE YOU WILL NOT BE CONSIDERED FOR THE OTHERS FOR THE CURRENT YEAR.
Masonic Bursary – To qualify for a Masonic Bursary, you must be a member of a Lodge under the jurisdiction of the Grand Lodge of Prince Edward Island, or his wife, widow, son, daughter, brother or sister. The member must be (or have been at the time of his death) a member in good standing in his Lodge.
T. Arthur Dawson Scholarship -To qualify for a T. Arthur Dawson Scholarship, you must be a member of a Lodge under the jurisdiction of the Grand Lodge of Prince Edward Island, or his wife, widow, son or daughter. The member must be (or have been at the time of his death) a member in good standing in his Lodge. The scholarships can be awarded annually for up to four years or the completion of a primary degree.
C. Gordon Lord Scholarship – To qualify for a C. Gordon Lord Scholarship, you must be a member of a Lodge under the jurisdiction of the Grand Lodge of Prince Edward Island, or his wife, widow, son or daughter. The member must be (or have been at the time of his death) a member in good standing in his Lodge. The scholarships can be awarded annually for up to four years or the completion of a primary degree.
By making an application for the Bursary or Scholarship, you are authorizing the publication of your name and / or picture should your application be accepted.
PLEASE COMPLETE APPLICATION CLEARLY
Version November 7, 2005
Section A – Applicant (Name as it should appear on cheque)
1. Name in full ____________________ __________ __________
Last First Initial
2. Mailing Address _________________________________________________
3. Date of birth / / Phone__________________ Place of Birth____________
DD MM YYYY
4. Name of Mason in Prince Edward Island jurisdiction making you eligible for a bursary or scholarship:
Mason’s Name _________________________________________
Lodge Name _________________________________________
5. If you are not a qualifying Mason applying, what is your relationship to the above named Mason?
(Circle one) Wife, Widow, Son, Daughter, Brother, Sister
Grandchildren do not qualify
Section B – Scholastic record
1. What is the last year or grade completed successfully?________________________
2. Name of institution___________________________________
3. A copy or transcript of your most recent set of marks must accompany this application or arrangements be made to send it by separate mail.
Section C – Financial information of the Applicant
1. Estimated cost of expenses for the coming year
Tuition $________ Books $________ Accommodations $ _________
Travel $ _________ Other $ ________ Total $ __________
2. How much money do you have on hand? $___________________________________
3. What other sources of financing do you have? (Estimated amount of money available)
(A) From employment $ _________________________________________________
(B) From University Aid $ _________________________________________________
(C) From a Student Loan $ ________________________________________________
(D) From Parental (or Guardian) Aid $ ______________________________________
4. Have you received or applied for other Scholarships or Bursaries for the coming educational year?
If yes, explain _______________________________________________________________________________
5. Is there any other specific information you would like the committee to consider when reviewing your application? (Explain- Attach a separate sheet if necessary
Section E – Future plans
1. Name of the Educational Institution you plan to attend?_____________________________
2. Proposed course?____________________________________________________________
3. Can you attend a personal interview, if necessary, in August? Yes ___ No ___
Section F – References
1. Give names, addresses and phone number of three people other than relatives whom we may contact for information about you.
Section G – Parent(s) (or Guardian(s)
1. Name(s) in full_________________________________________________________________
3. Occupation Father_____________________________________________________
Version November 7, 2005
5. Dependents of Parents (or Guardian)
Applicant’s Signature: ____________________________________ Date __________20___
Authorization to publish name and / or picture:
By signing this application you hereby authorize the publishing of your name and / or picture in a newspaper or other publication should your application be accepted
If you have any questions or want to confirm your application has been received, please contact the Grand Secretary at 902-894-3443 or email email@example.com
Note: If your application is accepted, cheques will be made payable to you and the Educational Institution you will be attending
The Following Is To Be Completed Before Being Submitted:
Lodge Secretary’s Verification:
I, _________________________________, Secretary of _______________________ Lodge No. ____ have reviewed this application and I am satisfied that the above named Applicant is eligible to apply for a Masonic Bursary, T. Arthur Dawson Scholarship or C. Gordon Lord Scholarship and the Applicant meets the guidelines as identified on page one. I further verify the Applicant is a Mason in good standing, or is the family member of a Mason who is in good standing now or was at the time of his death.
Lodge Secretary Signature ____________________________
MUST BE RECEIVED NO LATER THAN JULY 31
Mail application to:
The Grand Lodge of Prince Edward Island
P.O. Box 337
Charlottetown, PE C1A 7K7
Version November 7, 2005