Student Scholarship Form SEWF 2013 Student Scholarship Application October 2-4, 2013 Calgary, Canada I. Personal Data: Tell us about yourself Last Name* First Name* Country of Citizenship* Country of Birth (if Different) E-mail :* Phone Number* Home Address :* Street Address Street Address Line 2 City State / Province Postal / Zip Code Please Select United States Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan The Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Brazil Brunei Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile People’s Republic of China Republic of China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Cook Islands Costa Rica Cote d’Ivoire Croatia Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands Faroe Islands Fiji Finland France French Polynesia Gabon The Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati North Korea South Korea Kosovo Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macau Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia Moldova Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Nagorno-Karabakh Namibia Nauru Nepal Netherlands Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Turkish Republic of Northern Cyprus Northern Mariana Norway Oman Pakistan Palau Palestine Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Islands Poland Portugal Puerto Rico Qatar Romania Russia Rwanda Saint Barthelemy Saint Helena Saint Kitts and Nevis Saint Lucia Saint Martin Saint Pierre and Miquelon Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia Somaliland South Africa South Ossetia Spain Sri Lanka Sudan Suriname Svalbard Swaziland Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Timor-Leste Togo Tokelau Tonga Transnistria Pridnestrovie Trinidad and Tobago Tristan da Cunha Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom Uruguay Uzbekistan Vanuatu Vatican City Venezuela Vietnam British Virgin Islands US Virgin Islands Wallis and Futuna Western Sahara Yemen Zambia Zimbabwe Other Country Affiliation(School)* Program/Degree* Duration of Program (Years)* Year of Expected Graduation* Summary of Language Ability Native Language Non-Native Languages Please indicate your proficiency in languages (speaking, writing, reading) on a scale from 1 to 5 (1 being basic and 5 being fluent): Questions Why is social enterprise/social business of interest you? Why are you interested in attending and volunteering at the SEWF 2013? Maximum 150 Words 0/150 Availability I am committed to attend the volunteer orientation in Calgary prior to the SEWF On October 1, 2013 at 8:00 a.m. MDT). YES NO I am available and committed to volunteer for the three full days of October 2-4. YES NO Resume/CV Please attach a detailed resume/CV (Word or PDF formats only) that indicates your educational and professional experience. Please do NOT include any other attachments or supplemental information unless requested. Resume/CV* Calgary-Based Candidates Would you be willing to host/provide accommodation for an international volunteer? (YES or NO). If YES, describe the accommodations you would be able to provide (i.e., in your home? Location? Duration of stay?) Deadline: Submit the completed application form and your most recent resume/CV by Monday, July 16, 2013 (by 5:00pm MDT) Submit Clear Form Print Form Should be Empty:
