2013 Scholarship Applicati 2013 Scholarship ... - UFCW, Local 832

SCHOLARSHIP ELIGIBILITY CRITERIA2013 Scholarship Applicationapply online at www.ufcw832.comQuestions? call 204-775-8329 or 1-877-775-83291. I, as the student applying for this scholarship, am presently employed by a company that hasagreed to make contributions to the Education and Training Trust Fund (see last page).2. I have been a member in good standing with UFCW Local 832 since August 1, 2012.3. I have never received a UFCW Local 832 scholarship award (either General or Workplace/Sector specific).4. I am applying for a scholarship to assist with costs related to the following academic year: 2012/13 Academic Year (Fall 2012 – Spring 2013) 2013/14 Academic Year (Fall 2013 – Spring 2014)UFCW LOCAL 832 MEMBER INFORMATION(Member & Student must be the same person)5. Name Birth date M/ D/ Y/AddressCity Province MB Postal CodeTelephoneEmail6. Employer Store No. (if applicable)7. Department Date of Hire M/ D/ Y/SCHOLARSHIP INFORMATION8. Members applying for a workplace specific scholarship (b) and (c) will also be entered intocompetition for the General Scholarship (a). You may check more than one box below, butonly one scholarship will be awarded per recipient.(a) General Scholarship (60 available) $500 (b) Bernard Christophe Scholarships:One Safeway Member $1500 One Westfair Member $1500 (c) Robert Ziegler Scholarship:One Maple Leaf Member $1500 Manitoba Food and Commercial WorkersEducation and Training Trust Fund Scholarship

2013 Scholarship Applicationapply online at www.ufcw832.comQuestions? call 204-775-8329 or 1-877-775-8329PRIVACY PROTECTION13. In order to comply with privacy laws, this page must be signed by anyone taking courses orusing services at the UFCW Training Centre.The UFCW Training Centre has developed policies and procedures to safeguard your privacyand protect your personal information.We collect personal information about you for our files. We collect this information when youfill out forms, in interviews and over the telephone. This information is kept in our secureelectronic and paper filing systems. We use this information for: reports, statistics,enrollment, communication, awards, program development, employment services,recruitment, advertising, program monitoring and accountability, or other Training Centreoperational functions.Where required, we will share your information with third parties. For example, some adulthigh school information is shared with the Province and Winnipeg Technical College. Somecareer transition information is shared with the Province. Some scholarship information isshared with post-secondary institutions.Your personal information will not be sold to third parties.PERSONAL INFORMATION CONSENT14. I hereby authorize the UFCW Training Centre to collect personal information about me. Bysigning this form, I consent to the use of my personal information by the UFCW TrainingCentre to: Verify my UFCW Local 832 membership Communicate with me about the UFCW Training Centre, for example: courseregistrations, scholarship applications, etc. Share with third parties (see above)I agree that my personal information can be used for these purposes now, and in the future.I understand that I can withdraw my consent in writing at any time. However, I also understandthat this will mean that I will no longer be able to attend courses or access services(including scholarship monies) at the UFCW Training Centre.___________________________________________________________Signature of Member (must be the same person as the Student) DateIf under 18 years of age, please have this form signed by a parent or guardian._____________________________Signature of Parent/Guardian_______________________Relationship to ApplicantManitoba Food and Commercial WorkersEducation and Training Trust Fund Scholarship

UFCW Local 832Education & Training Trust Fund ContributorsLocal 832 members who work for the following employers are eligible toapply for a UFCW Local 832 Scholarship, a Bursary and receive priorityenrolment and reduced rates at the UFCW Education and Training Centre.ACL VirdenAramark: CFB 17 th Wing, Refreshment ServicesArcturus Realty Corp.Avion Services Corp.Brandon Community OptionsBrewers' Distributor Ltd.Bunge CanadaCanada Safeway Ltd.Canada Safeway Ltd. Gas BarsCNIBCoca-Cola Refreshments Canada Company:Brandon, WinnipegEPIC de St. Malo Inc./SMILE of St. Malo Inc.(La Residence, Red River Workshop)First CanadaFort La Bosse School DivisionFreezercoGardaGate GourmetGourmet Baker Inc.Granny's PoultryGroup Westco Inc.Hewlett PackardHylife FoodsIGA-Maples Garden MarketIGA-Otineka Mall, The PasIkwe-WiddjittiwinImpact / Invicta SecurityIntegrated Messaging Inc.J. C. Foods Ltd.Krown ProduceLorette MarketplaceLucerne Foods Ltd. BreadLucerne Foods Ltd. MilkMcCain FoodsMcKenzie Seeds Ltd: Office, PlantMaple Leaf Consumer FoodsMaple Leaf Fresh Foods: BrandonNaleway FoodsNorthern MeatsNPF CFB ShiloR. W. Packaging Ltd.Shopper's Drug Mart: RegentSobeys BurrowsSodexo Canada Ltd.Souris Valley FoodsSyn-Tex Convertors Ltd.Sysco Food Services WinnipegThe Fairmont WinnipegUFCW 832 RepUnicity Taxi Ltd.United WayVantage Foods (MB) Inc.VersaCold: Dawson, Jarvis,VersaCold TransportationWestfair Foods Ltd.Scholarship application deadline—June 30thwww.ufcw832.com