Scholarship Form

Important Note: You must read the application Criteria and Guidelines before completing this application.

All fields must be completed.

Personal Information

First Name (required)

Middle Initial

Last Name (required)

Permanent Address (required)

City (required)

Province (required)

Postal Code (required)

Your Email (required)

Gender (required)
 Male Female

Citizenship Status (required)
 Canadian Citizen Permanent Resident

I will be entering:

 My first year My second year of college or university in the application year

My Connection to the Office Products Industry:


NOTE: Select only one of the three options below

1. I am currently working for a COPA member

 Yes No

Company name

Work Period Start Date (mm/yyyy):

2. I previously worked for a COPA member
 Yes No

Company name

Work PeriodStart Date (mm/yyyy):

Work Period End Date (mm/yyyy):

3. My family member works for a COPA member company
 Yes No

 Mother Father Guardian Grandmother Grandfather

Company name

Person's name

Program of Study

Name of Institution (required)

Program (required)

Expected start date (required - mm/yyyy):

Expected completion date (required - mm/yyyy):

Certificate, diploma or degree expected(required)

Academic History

Name of high school:(required)

Start Date :(required - mm/yyyy)

Completion Date:(required - mm/yyyy)

Grade Avg (e.g. 80%) Required:


Name of Post secondary institution (Required if applying for 2nd Year College/University):

Program:

Start Date (mm/yyyy):

Completion Date (mm/yyyy):

Grade Avg (e.g. 80%):

Attachments

Letter from your employer, or your parent/grandparent/guardian’s employer

Official transcript for your last academic year

Copy of proof of Canadian Citizenship or Permanent Resident status

Preliminary acceptance letter from college or university (if first year student); or tuition invoice, if available

Privacy Statement and Application Agreement

Rules and Regulation Guidelines:

1. COPA reserves the right to authenticate all information pertaining to the application.
2. COPA reserves the right to use recipient’s name or photograph for promotional purposes.
3. COPA reserves the right to change any dates stated on the application form.
4. All information on the application will be held in the strictest confidence. Personal information under the control of COPA shall not, without the consent of the individual to whom it relates, be used by COPA except: (a) for the purpose for which the information was obtained or compiled by COPA; or (b) for a use consistent with that purpose.
5. Senior COPA Staff will conduct the application pre-screening to identify all applications that are complete and meet the minimum requirements. The COPA Board of Directors will then draw ballots to select winners from the qualifying applications. All decisions are final.
6. All successful applicants will be notified by COPA.
7. By participating in the program, recipient agrees to release, discharge and hold harmless COPA, its affiliates, subsidiaries, licensees, licensors, retailers, suppliers and agencies and each of their respective officers, directors, shareholders and employees from any injury, loss or damages of any kind.
8. By participating, recipient agrees to these Official Rules (including eligibility requirements) and to the decisions of
COPA whose decisions are final and binding in all matters pertaining to this program. This program is subject to all Federal, Provincial and Municipal laws and regulations.
9. Scholarships will be awarded in Canadian dollars for up to one year in the amount determined by COPA for the specified award year. This award is non-renewable. The Canadian Office Products Association reserves the right to change the scholarship value and number of scholarships available in any academic year.

Acknowledgements and Signature:
I have read the application guidelines, rules and regulations of the COPA Scholarship Fund and hereby declare that:
 1. I have personally written the attached application, addressed all required issues fully and completely and that to the best of my knowledge the information provided in this application is true. I understand that the information provided may be verified upon request.
 2. I consent to the use of my personal information for: (a) processing of the application; and/or (b) if I receive this award, publication of my name, photograph, work history, and study plans, the name of my parent or guardian working in the office products industry and my connection to the office products industry.
 3. I acknowledge and agree to the above privacy statements and use of my personal information by the Canadian Office Products Association.
 4. I have read and agree to all of the official rules and regulations and acceptance conditions of the COPA Scholarship Fund. (Parent/guardian of applicant if not age of majority)