Jim Lorway Memorial Bursary

Deadline: Friday, May 23, 2008
Full Name
Email
Street
City/Town
Postal Code
Current School
Name of School Official
Title of School Official
Letter of support from teacher or guidance counselor
Future Academic Plans
University/College
Program
Relationship to MacLeod Lorway Group client(s) (Please complete at least one)
First Relationship
Full Name
Street Address
Relationship
Office	Please Select BH MorashInsurance Guysborough Insurance Island Insurance MacKenzie Insurance MacLeod Lorway Insurance McKillop & Johnson Insurance Veinot Insurance
Second Relationship
Full Name
Street Address
Relationship
Office	Please Select BH MorashInsurance Guysborough Insurance Island Insurance MacKenzie Insurance MacLeod Lorway Insurance McKillop & Johnson Insurance Veinot Insurance
Third Relationship
Full Name
Street Address
Relationship
Office	Please Select BH MorashInsurance Guysborough Insurance Island Insurance MacKenzie Insurance MacLeod Lorway Insurance McKillop & Johnson Insurance Veinot Insurance
Fourth Relationship
Full Name
Street Address
Relationship
Office	Please Select BH MorashInsurance Guysborough Insurance Island Insurance MacKenzie Insurance MacLeod Lorway Insurance McKillop & Johnson Insurance Veinot Insurance
Fifth Relationship
Full Name
Street Address
Relationship
Office	Please Select BH MorashInsurance Guysborough Insurance Island Insurance MacKenzie Insurance MacLeod Lorway Insurance McKillop & Johnson Insurance Veinot Insurance
Tell us about yourself – what sports you play, what activities you enjoy, what your future goals are:
Successful candidates will receive their bursaries upon verification of enrollment in a recognized post-secondary program.