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.

Instruction Sheet

NOTE:

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.

Qualification:

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.



Promotion Authorization:

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

Email address_________________________________

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.

1. __________________________________________________________________

2. __________________________________________________________________

3. __________________________________________________________________

Section G – Parent(s) (or Guardian(s)

1. Name(s) in full_________________________________________________________________

2. Address_______________________________________________________________________

3. Occupation Father_____________________________________________________

Mother_____________________________________________________

Version November 7, 2005

5. Dependents of Parents (or Guardian)

a____________________________Age_____ d._______________________________Age____

b.___________________________Age_____ e._______________________________Age_____

c.___________________________Age_____ f.________________________________Age_____

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      grandsecretary@freemasonry.pe.ca

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 ____________________________

Date _____________________________

MUST BE RECEIVED NO LATER THAN JULY 31

Mail application to:

The Grand Lodge of Prince Edward Island

Bursary Committee

P.O. Box 337

Charlottetown, PE   C1A 7K7

Version November 7, 2005