Information | Scholarship Application Form | Juan de Fuca Minor Hockey Association

First Name:*

Last Name:*

Date of Birth:*

Email:*

Phone:*

Current Team:*

Future Course of Study - First Choice (include program, institution, and estimated cost):*

Future Course of Study - Second Choice (include program, institution, and estimated cost):

Future Course of Study - Third Choice (include program, institution, and estimated cost):

Hockey Participation - Most Recent (list Season, Division, Team and any awards received):*

Hockey Participation 2 (list Season, Division, Team and any Awards Received):

Hockey Participation 3 (list Season, Division, Team and any Awards Received):

Hockey Participation 4 (list Season, Division, Team and any Awards Received):

Hockey Participation 5 (list Season, Division, Team and any Awards Received):

Referee Experience - Most recent first (List season(s), Divisions refed, and any Awards received):

Community Activity (include the year and a description of your involvement):

Reference 1 (List the Name, Address and Phone Number of an individual familiar with your contributions to hockey and the community):*

Reference 2 (List the Name, Address and Phone Number of an individual familiar with your contributions to hockey and the community):*

Other Awards (List any other Scholarships, Bursaries, Awards or other Academic recognition that you have been awarded, including the value of such awards):

Additional Comments:

You must supply the following:

Letter of Support from the applicants Hockey Coach and/or the Referee-in-Chief
Letter of support from the applicants Association President
Copy of most recent school transcript showing grade status
Proof of registration to Post-Secondary or continuing studies training/program
Letter briefly describing your experiences through JdMFHA, Good Citizenship and Community support

Please email these documents in one email to the Treasurer - treasurer@jdfminorhockey.com with the subject - Scholarship Application - Your Name