WCRC Legacy Scholarship Application Form Scholarship Application If you are human, leave this field blank. Applicant Information First Name * Last Name * Address: * Address: Address: Address: City City State/Province State/Province Zip/Postal Zip/Postal Country Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Brazil Brunei Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Colombia Comoros Congo Costa Rica Côte d'Ivoire Croatia Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic East Timor Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Fiji Finland France French Guiana French Polynesia Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guam Guatemala Guinea Guinea-Bissau Guyana Haiti Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Jamaica Japan Jordan Kazakhstan Kenya Kiribati North Korea South Korea Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Mauritania Mauritius Mexico Micronesia Moldova Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands New Zealand Nicaragua Niger Nigeria Norway Northern Mariana Islands Oman Pakistan Palau Palestine Panama Papua New Guinea Paraguay Peru Philippines Poland Portugal Puerto Rico Qatar Romania Russia Rwanda Saint Kitts and Nevis Saint Lucia Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia and Montenegro Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa South Sudan Spain Sri Lanka Sudan Suriname Swaziland Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Togo Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States Uruguay Uzbekistan Vanuatu Vatican City Venezuela Vietnam Virgin Islands, British Virgin Islands, U.S. Yemen Zambia Zimbabwe Country Phone Number * Email Address * Consent PRIVACY CONDITIONS: Please note these conditions before submitting this application: The information provided in this application is true, accurate, and complete. I am aware that providing incomplete or false information will render my application null and void and will not permit me to compete for this scholarship. I authorize Ringette Calgary to verify student information included to determine eligibility. I authorize the Selection Committee to access my playing, coaching and officiating history as required. I authorize Ringette Calgary to make copies of this application and distribute it to the Selection Committee for the purpose of review. No applicant names will be included in this process. Privacy: * I understand the Privacy Conditions CONSENT FOR PUBLIC RECOGNITION: Checking yes on this consent form permits Ringette Calgary to publicly recognize your achievement as a recipient of the scholarship. If selected for this scholarship, consent is given to Ringette Calgary to publish the student’s name, school location, and scholarship received. It is understood that not agreeing to this consent will not prejudice the consideration of student scholarship applications. Consent * YES, I consent to public recognition NO, I do not consent to public recognition Academic Name of Canadian Post-Secondary Institution currently attending: * City * Province * Field of Study: * Ringette Playing Experience Use a separate line for each season. Season Team Division City Add Remove Coaching Certfication Coaching Certification Respect In Sport CI CSI Ringette Coaching Experience Season Team Division Position Head Coach Assistant Coach On-Ice Helper Junior Coach Add Remove Ringette Officiating Certification Level # Years as an Active Official Ringette Committee Experience Do you have any experience sitting on Ringette boards or committees? Season Position Committee Association Add Remove Ringette Work Experience Please list any Ringette experiences where you received payment for your duties. ie. Ringette Schools. Use a separate line for each year you may have worked at the same task. Month/Year Task Commitment: < 5 hrs 5-10 hrs 11-20 hrs > 20 hrs Worked For: Add Remove Other Ringette Volunteer Experience Can include on ice assistance, evaluating, tryouts, clinics, etc. Use a separate line for each year you may have volunteered at the same task. Month/Year Task Commitment: < 5 hrs 5-10 hrs 11-20 hrs > 20 hrs Volunteered For: Add Remove Other Volunteer Experience Can include community, school, events, etc. Use a separate line for each year you may have volunteered at the same task. Month/Year Task Commitment: < 5 hrs 5-10 hrs 11-20 hrs > 20 hrs Volunteered For: Add Remove Have you ever been assessed a Misconduct Penalty? * No Yes How many Misconducts have you received? Have you ever been assessed a Match Penalty? * No Yes How many Matches have you received? In a few words, please tell us how Ringette has impacted your personal development. * Your Proof of Enrollment * Uploading Files. Please Wait. Drop a file here or click to upload Choose File Maximum upload size: 25MB Provide proof of enrollment at a Canadian Post-Secondary Institution. After you hit submit your file will be uploaded and you will receive an on screen confirmation that we have received your application. You will also receive an email confirming this. reCAPTCHA
