Nova Scotia Salmon Association

Scholarship Award

 APPLICATION FORM

Date: _________________

Personal Information

Name:	__________________________________________________
Present Address:	__________________________________________________
	__________________________________________________
Permanent Address:	__________________________________________________
	__________________________________________________
Area Code/Telephone #:	__________________________________________________

 

 

Section A - Scholarship Applicants must:

1) have undertaken, or be in the process of undertaking scholarly pursuit related to the enhancement or conservation of the Atlantic salmon and /or Trout

2) propose to publish, or have published, an article or scientific paper in any field which features the enhancement of Atlantic salmon and/or Trout  

 

 

Educational Information

Program of study:	__________________________________________________
Major/Faculty:	__________________________________________________
Name of College/University:	__________________________________________________
Location:	__________________________________________________
Duration of Program:	__________________________________________________
Year in Program:	__________________________________________________
Date of Graduation:	__________________________________________________

 

 

Educational Institutions Attended

Name:	__________________________________________________
Location:	__________________________________________________
Name:	__________________________________________________
Location:	__________________________________________________

 

 

Section B - Award Applicants must:

1) promote the cause of Atlantic salmon and Trout by outstanding leadership or participation

2) be engaged in endeavors of an Association which results in the conservation of Atlantic salmon and Trout

 

Conservation Information

Name of Conservation Association: __________________________________________

 

Address of Conservation Association:_________________________________________

                                                           ______________________________________________

 

Area of Undertaking: County: ________________                   River: __________________

 

Type of Project: Education ___   Stream Restoration ___   Advocacy___   Other ___

 

 

General Information

 

Please attach a statement of general interest and activities, proposed course of study and present intention for future career development (maximum limit 500 words) or summarizing the Applicants endeavors to conserve the Atlantic salmon and/or Trout in Nova Scotia..

 

References

Names and addresses of two references will provide information regarding the applicant's qualifications. One reference should be a person under whom the applicant studied or worked with in pursuit of Atlantic salmon or Trout conservation.

Name:	__________________________________________________
Address:	__________________________________________________
	__________________________________________________
Telephone:	__________________________________________________

 

Name:	__________________________________________________
Address:	__________________________________________________
	__________________________________________________
Telephone:	__________________________________________________

 

I agree to allow the NSSA Scholarship Committee to verify the information presented in this application.

Signature

______________________________

Date

__________

 

Please mail application by October 30, 2005 to:

 

 

NSSA SCHOLARSHIP COMMITTEE
102 Pomquet Road
RR#7 Antigonish, Nova Scotia
Canada
B2G 2L4