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Guru Nanak College of Nursing Bursary Application
IMPORTANT: You may only submit this form one time. Please review your answers before submitting.
You may submit answers in Punjabi or English.
* Indicates required question
Email
*
Your email
Your full name
*
Include first, middle and last name.
Your answer
Your program of study
*
General Nurse-Midwifery (GNM) diploma
Bachelor of Science in Nursing (BSc.N) degree
Your CURRENT year of study
*
High school 10+2
Year 1
Year 2
Year 3
Year 4
Your student ID number
*
Your answer
Your date of birth
*
MM
/
DD
/
YYYY
Your home address - HOUSE & STREET
*
Your answer
Your home address - ADDITIONAL LINE
E.g. for unit number or other identifying information
Your answer
Your home address - CITY
*
Your answer
Your home address - DISTRICT
*
Your answer
Your home address - STATE
*
Your answer
Your home address - COUNTRY
*
Your answer
Your e-mail address
*
Your answer
Your personal mobile phone number
*
Your answer
Your father's name
*
Your answer
Your father's occupation
*
Your answer
Your mother's name
*
Your answer
Your mother's occupation
*
Your answer
Your family's estimated combined income for the year
*
Your answer
How are you currently supporting financial payments for your studies?
*
Your answer
Are you eligible for government support for your school fees?
*
Your answer
Please list your brother's names, their ages, and their occupation
*
Your answer
Please list your sister's names, their ages, and their occupation
*
Your answer
Please provide two non-family references and their phone numbers
*
Your answer
Do you agree to provide us with photographs of yourself or to have your photo taken, both of which will be published for public distribution by our organization if you are selected for this bursary?
*
Yes
Required
Do you agree to be contacted by Guru Nanak Mission Medical and Educational Trust, Canada India Education Society and their related organizations?
*
Yes
Required
Your personal statement
*
Please describe:
a) A little about yourself
b) Why you need financial assistance
c) What you hope to do after graduation (e.g. post-graduate studies, work, pursue additional areas of study, etc.).
MINIMUM 300 WORDS.
You can write in Punjabi.
Your answer
Is there any additional information you think we should know about your financial or personal situation?
IMPORTANT:
Please do not repeat information requested or given above. This is an opportunity to let us know information that may affect your financial standing or ability to continue your studies.
Your answer
Attestation
*
I confirm that the information provided is true and accurate. I have not misrepresented or misled the selection committee by my answers in any way. I have also provided all information that may be pertinent to understanding my current or future financial situation and my ability to complete my nursing studies and to become a licensed, practicing nurse. I understand there may be consequences for providing false or misleading information on this application form, including disqualification.
Required
Send me a copy of my responses.
Submit
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This form was created inside of Dhahan Prize for Punjabi Literature.
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