Date Sunday, January 20, 2019

Part A - Applicant Information

*Student's First Name
*Student's Last Name
*Student's Birth Date
*Secondary/high school you attended or secondary/high school you are currently attending
*Year you graduated from secondary/high school or the year you will graduate from secondary/high school

Address where you want correspondence sent:
*Street Address
*City/Town		*Postal Code

Name of Parent/Guardian who is a member in good standing of OSSTF/FEESO
If the member is deceased, please provide month/year of passing away.
*First Name
*Last Name
*Is the applicant a:
	Child of the member Stepchild of the member Ward of the member
*OSSTF/FEESO Membership #
*OSSTF/FEESO District Name	- Select - 01 Ontario North East District 02 Algoma District 03 Rainbow District 04 Near North District 05A Northern Shield District 05B Rainy River District 06A Thunder Bay District 06B Superior-North District 07 Bluewater District 08 Avon Maitland District 09 Greater Essex District 10 Lambton Kent District 11 Thames Valley District 12 Toronto District 13 Durham District 14 Kawartha Pine Ridge District 15 Trillium Lakelands District 16 York Region District 17 Simcoe District 18 Upper Grand District 19 Peel District 20 Halton District 21 Hamilton-Wentworth District 22 Niagara District 23 Grand Erie District 24 Waterloo District 25 Ottawa-Carleton District 26 Upper-Canada District 27 Limestone District 28 Renfrew District 29 Hastings-Prince Edward District 30 PSAT District 31 Franco-Nord Ontarien District 32 Centre-Sud-Ouest de l'Ontario District 33 District de l'Est 34 Independent Educational Programs District 35 Universities and Colleges District

*Bargaining Unit	- Select - Teacher Occasional Teacher PSSP Educational Support Staff University Other
	If other, specify

*Work Location
*Home Telephone
Cell Phone
*Personal E-mail
* Is your permanent address the same as above?		YesNo
If no, please provide your permanent address
Street Address
City/Town		Postal Code

*a) Name of post-secondary institution(s) where you will be attending OR where you have applied for the upcoming year

*b) Name of program in which you are currently enrolled OR have applied to for the upcoming year.

*	c) Length of your progam (number of years of study)

*	d) The completed Federation Family Education Fund Application has a deadline date of April 15 of any given year. The scholarship awarded for this Fund is for the academic school year, starting in September, not the current year. In September, what program year will you be enrolled (i.e. year 1, year 2, etc.)

*	e) Is this your first post-secondary degree, diploma, certificate or apprenticeship?	YesNo
	If you answered "No", what degree, diploma, certificate or apprenticeship did you receive?
	In what year did you receive it?

*	f) Have you ever received an OSSTF/FEESO Family Federation Education Fund previously?	YesNo
	If "Yes", what year?

I hereby consent to the collection and use of the above-noted information by the Ontario Secondary School Teachers’ Federation. This information shall be used exclusively for the purposes of union administration and the representation of our members.
*Name of Parent/Guardian:

Please make sure you have answered all questions completely and accurately before clicking the "Submit" button.