Football Québec
[pic] Alouettes Bursary Program
2018 bursary application form
Secondary and college levels
Family name: _____________First name(s): ________________________
You must complete a form for each category in which you are applying.
Check the applicable bursary category(:
Secondary level:
| |Athletic Excellence for 10th grade graduates | | |Academic Excellence for 11th grade graduates |
| |Perseverance for 11th grade graduates | | |Academic Excellence for 10th grade graduates |
| |Perseverance for 10th grade graduates | | |Leadership for 10th or 11th grade graduates |
| |College level: |
| |Athletic Excellence | | | |Leadership |
| |Academic Excellence | | | | |
|Procedure |
|Read the eligibility and selection criteria. |
|Fill out the bursary application form, providing maximum information, all-star selections, statistics, etc. For the leadership or |
|perseverance category, the last 2 pages of this form must be completed. |
|For secondary students, provide grades for the third semester of Grade 10 or 11 by June 15, 2018. For college level students, send |
|complete transcript of 2017-2018. |
|Send by email a well identified high resolution (at least 600 KO) action shot where the player is clearly visible. |
|For RSEQ LEAGUES, return the form by June 22nd, 2018 to Mr. Jonathan Collin by e-mail (preferably) at jonathan.collin@ |
|For Football Québec civil leagues, return the form by June 22nd, 2018 by e-mail (preferably) at info@football.qc.ca or by regular post |
|to: |
|Football Québec |
|4545, ave. Pierre-de Coubertin, Montréal (Québec) H1V 0B2 |
|The deadline for candidate submissions is Friday, June 22nd, 2018. |
|[pic] |[pic] | |
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Program administered by the Quebec Foundation for Athletic Excellence and Football Québec, in collaboration with the Réseau du sport étudiant du Québec (RSEQ).
PERSONAL INFORMATION
Family name:__________________________First name(s): _______________________
ADDRESS ADDRESS OF PARENTS (if different)
_______________________________________ _______________________________________
(Number, street, apt.) (Number, street, apt.)
_______________________________________ _______________________________________
(City, province) (City, province)
__________________ (_____)_____________ ___________________(____)______________
(Postal code) (Telephone) (Postal code) (Telephone)
(____)_________________________________ _______________________________________
(Cellular phone number) (Social insurance number)
_______________________________________ _______________________________________
(Date of birth day/month/year) (E-mail)
SPORTS INFORMATION
|YEAR |TEAM OR CLUB (Jersey Number and Position) |COACH |
|2016-2017 | | |
|2017-2018 | | |
|2018-2019 | | |
Have you already been part of the excellence programs of Football Québec, Challenge Wilson, or the MU15, MU17 or MU20 programs, Team Canada?
If yes, indicate which program and when____________________________________
______________________________________________________________
INDIVIDUAL STATISTICS
Provide individual statistics for position(s) played: pass completion percentage, yards gained, touchdowns, points, field goals, success percentage, average yards per field goal, average yards per punt, punt returns, kickoff returns, passes caught (percentage and average yards), tackles, sacks, special teams tackles, interceptions, fumble recoveries, etc.
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
SPORTS AWARDS
All-star selections, offensive or defensive player of the year, team player of the year, school athlete of the year, student-athlete, etc.
|MONTH/YEAR |NATURE OF AWARD |
| | |
| | |
| | |
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Athletic objectives 2018-2019
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
ACADEMIC INFORMATION
|YEAR |INSTITUTION |MAJOR |DIPLOMA |
|2016-2017 | | | |
|2017-2018 | | | |
|2018-2019 | | | |
Will you be a full-time student in September, 2018? Yes No
Have you received academic honours or distinctions?
Yes No
|Month/Year |NATURE OF AWARD |
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N.B.: Please include a copy of your secondary or college academic grades – MANDATORY
RESERVED FOR PERSEVERANCE BURSARY APPLICANTS
Explain why you are a good candidate to receive a perseverance bursary this year. What methods did you use to achieve your goals?
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RESERVED FOR LEADERSHIP BURSARY APPLICANTS
Describe the deeds or ongoing activities in which you have participated to change or improve conditions in your community. Also, describe the roles and responsibilities that demonstrate your leadership abilities, particularly your capacity for motivating and leading others.
Indicate the duration and extent of your involvement. You may include personal references or documents in support of your application.
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Formulaire révisé le 14 mai 2018.
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