
Mary Lynn Higgins Youth Fund
Application Form
2007/2008
Student’s Name(s): ___________________________________________________________
Teacher’s Name: _____________________________________________________________
Teacher’s Email: _____________________________________________________________
School Name: _______________________________________________________________
School Phone: _______________________________________________________________
School Address: _____________________________________________________________
_____________________________________________________________
Tour Operator Name: _________________________________________________________
Tour Operator Representative: _________________________________________________
Destination: _______________________________Date of Travel: _____________________
Tour Price Per Student: $____________Amount of Scholarship Required: $___________
Teacher’s Signature: _________________________________Date: ____________________
Principal’s Name: ____________________________________Date: ____________________
Principal’s Signature: __________________________________________________________
5 CLUBINE COURT
AURORA, ON L4G 4X7
Email:
inquiry@marylynnyouthfund.comWebsite:
www.marylynnyouthfund.com
Charitable BN/Registration # 83661 7365 RR000
COMPLETING THE MLH YOUTH FUND APPLICATION FORM
Instructions and Notes:
Scholarship Criteria
Elementary School Students: Letter for these students should include the following sections:
1. Reasons Student is Deserving of a Scholarship:
2. Fundraising efforts by the Student
3. Financial Circumstances:
High School Students: Letter for these students should include the following sections:
1. Reasons Student is Deserving of Scholarship:
2. Fundraising efforts by the Student
3. Financial Circumstances