Jason Lang Scholarship

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JASON LANG SCHOLARSHIPThis scholarship was established in memory of Jason Lang, a 17 year old high school student who was killed in a schoolshooting. The scholarship recognizes and rewards Alberta post-secodary students for their academic achievements andencourages them to continue in their undergraduate or professional program of study.Award Value - $1,000Eligibility CriteriaTo be eligible an applicant must:• be a Canadian Citizen or Permanent Resident (visa students are not eligible),• be an Alberta resident and to be considered an Alberta resident one of the following conditions must apply:- one parent must currently be residing in Alberta, or- Alberta is the last place you have lived for twelve (12) consecutive months before being a full-time student, or- you are married to an Alberta resident before the start of your qualifying year of study.• be enrolled in an undergraduate or professional program such as Law, Medicine, Pharmacy, Dentistry or VeterinaryMedicine at a participating post-secondary educational institution in Alberta,• be enrolled in a program of study which is a minimum of two years in length or greater, i.e. a program must offer aminimum of four academic terms or 64 weeks of academic instruction, excluding work term and/or co-op, and• have completed at least 80% of a full course load and achieved a minimum Grade Point Average of 3.2 on a 4.0 scalein the previous academic year during the fall and winter semesters.Students who are nominated for a scholarship and transfer to a non-participating post-secondary institution are eligible toreceive payment of the scholarship. Students must be continuing their post-secondary studies in the 2012-2013 academic yearand must provide confirmation of their full-time enrollment to Alberta Scholarship Programs.Students are not eligible for a Jason Lang Scholarship if they:• are enrolled in a one year certificate program,• are completing one year of a certificte program and transfer into another one year certificate program,• interrupt their post-secondary studies for more than one semester in the next academic year,• are recipients of a Louise McKinney Scholarship for the same period of study, or• have received the lifetime maximum of three Jason Lang Scholarships.Selection ProcedureStudents who meet the eligibility criteria are nominated by the Student Awards Office at the Alberta post-secondary institutionwhere they completed their qualifying year of studies.Payment of the AwardTo receive payment of the award, nominees must be:• continuing their post-secondary studies in the next academic year, either the fall or winter semesters, and• enrolled full-time, i.e. taking a minimum of a 60% of a full course load for a minimum of one semester.Students who are nominated in the fall semester receive their cheque in mid-December and students who are nominatedin the winter semester receive their cheque at the end of March.Submit your completed application form to the Student Awards Office at youreducational institution.
JASON LANG SCHOLARSHIPWe are collecting the personal information on this form under the authority of Section 33(c) of the Freedom of Information and Protectionof Privacy Act (FOIP Act), as being directly related to and necessary to determine your eligibility for a scholarship under the Alberta HeritageScholarship Act and to administer the Alberta Scholarship Programs. If you have any questions about the collection of this information,please contact Alberta Scholarship Programs, 4th Floor, 9940 106 Street, Edmonton, Alberta, T5K 2V1 Phone 780.427.8640.Personal InformationAlberta Student Number (go to www.education.gov.ab.ca to find your ASN or to obtain one)Social Insurance NumberLast Name (current full legal name) Please use upper and lower case.First Name and One Initial (current full legal name)Mailing Address (Include Apt. or Box Number)City/TownPrevious SurnameProvince Country Postal Code Area Code Telephone NumberGender Date of Birth Email Addressday month yearCITIZENSHIP (check one)CANADIAN CITIZEN or PERMANENT RESIDENT (Landed Immigrant)Note: Include a photocopy of permanent resident card or immigration long form. Visa students are not eligible.ALBERTA RESIDENCY**Do your parents currently live in Alberta? *Have you lived in Alberta all your life? If ‘NO’ sinceY N Y NEDUCATION INFORMATIONPrevious Academic Year: 2012-2013Name of ProgramName of Educational Institution Academic Year Start Date Academic Year End DatemonthyearLength of Program:YearsYear of ProgramOffice Use Only1st 2nd 3rd 4thStudent ID*If your parents do not currently reside in Alberta AND you have not lived in Alberta all your life, please includea letter explaining the time spent in Alberta as a non full-time student.29 8 8 8 1 2GRANT TOTAL AWD INSTIT PGM MO YR MO YR ORG ADDDisbursementEMO YR AUTHORIZATION AWARD KEY APP KEYRevised: March 2013
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Jason Lang Scholarship

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