Step 1 of 7 - PERSONAL INFORMATION 14% PERSONAL INFORMATIONName First Middle Initial Last Email Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Home PhoneCell PhoneWhich First Nation Community are you a member of?****Note: The Scholarship and Bursary Program is only available to registered band members from the communities of Gesgapegiag, Gespeg, and Listuguj.***Gesgapegiag, QCGespeg, QCListuguj, QC POST-SECONDARY, VOCATIONAL TRAINING, HIGH SCHOOL INFORMATIONWhen did you graduate from high school or your highest grade completed?Year or Grade Area of Study: Business Health Sciences Arts Fine Arts Indigenous Studies Social Work Education Engineering Please include Major, if any: If vocational student, indicate area of training: Are you a returning student? Yes No Vocational Student State year attending (e.g. 2nd, 3rd, 4th): Expected Program Completion Date MM slash DD slash YYYY Indicate which Term(s) do you plan to enroll in 2023-2024 Vocational Student Fall Term (Sept-Dec) Winter Term (Jan – Apr) Summer Term (May – Aug) Indicate which program you are applying for (select one):Note: Vocational students may only apply for the bursary program. Scholarship Bursary Have you applied to your First Nation for funding? Yes No Why? EMPLOYMENTAre you currently employed? Yes No How long have you been unemployed? Name of Employer Annual Employment NET Income Length of Employment Job Title Will you be employed during the school year? Yes No BUDGET INFORMATION - EXPENSESExpenses detailsTuition & feesSept - DecJan - AprMay – AugTotalBooksSept - DecJan - AprMay – AugTotalRent/MortgageSept - DecJan - AprMay – AugTotalUtilities/PhoneSept - DecJan - AprMay – AugTotalFoodSept - DecJan - AprMay – AugTotalTransportationSept - DecJan - AprMay – AugTotalChild CareSept - DecJan - AprMay – AugTotalClothingSept - DecJan - AprMay – AugTotalOther (identify)Sept - DecJan - AprMay – AugTotal BUDGET INFORMATION - INCOMEIncome detailsEmploymentSept - DecJan - AprMay – AugTotalFamily/PersonalSept - DecJan - AprMay – AugTotalBand/Community Living AllowanceSept - DecJan - AprMay – AugTotalBand/Community TuitionSept - DecJan - AprMay – AugTotalBand/Community BooksSept - DecJan - AprMay – AugTotalScholarshipsSept - DecJan - AprMay – AugTotalBursariesSept - DecJan - AprMay – AugTotalStudent LoanSept - DecJan - AprMay – AugTotalOther (identify)Sept - DecJan - AprMay – AugTotal Explain any special budget circumstances:Please describe your career goals:How did you hear about MMBC Scholarship and Bursary Program? MMBC Website Facebook First Nation Friend/Family Other Collection and Use of InformationI understand that the information submitted in and with this application will be used to assess my eligibility for the MMBC Scholarship and Bursary Program. I hereby certify that all the information provided on this application form and in all the documents accompanying are true, accurate and complete. I have read all the guidelines regarding the MMBC Scholarship and Bursary Program. By submitting this application, I agree to be bound by the guidelines of this program. I give my permission to the Mi’gmawei Mawiomi Business Corporation to collect my contact information so that I may receive information about potential employment, scholarship, and training opportunities. I also agree to allow the Mi’gmawei Mawiomi Business Corporation to publicly announce my name and display my picture if I am selected for an award. If the applicant is under the legal age to enter a legal agreement, the applicant will have their parent or legal guardian sign this document on the applicants behalf. I agree to the Collection and Use of Information Signature APPLICATION DOCUMENTSEssay- 500 to 1,000 words (1 to 2 pages) - How will this scholarship or bursary make a difference for you? Drop files here or Select files Max. file size: 96 MB. Latest transcripts (not applicable for vocational students)- Unofficial or official transcripts - From most recent school year - Envelopes do not need to be sealed Drop files here or Select files Max. file size: 96 MB. Acceptance/enrollment at Post-Secondary Institution or Vocational Training Institution/Facility- An Acceptance Letter is required if going into a new institution/facility -Returning students must submit a letter of enrollment that states you are considered full time. Drop files here or Select files Max. file size: 96 MB. Copy of Native Status- Copy of your native status card (front and back). If you do not have a status card, obtain a written letter from your Band to confirm your membership. Drop files here or Select files Max. file size: 96 MB. Copy of Void Cheque-Copy of a void cheque to where you would like the funds deposited. This is so we have your information on file in case you are selected for an award. Drop files here or Select files Max. file size: 96 MB.