Undergraduate Educational Bursary Award

Please read the undergraduate bursary information page and complete the tuition confirmation page located below before submitting the following form.

undergraduate bursary Information Page Download

undergraduate bursary Tuition Confirmation Page Download

undergrad bursary

Sponsor Member

Name(Required)

First Last

UA Card #(Required)

Address(Required)

Street Address Address Line 2 City Province Postal Code

Phone(Required)

Email(Required)

Dependent(Required)

Is the applicant a recognized dependent under the health and welfare plan with Edmonton Pipe Industry?

Hours Contributed(Required)

Have you contributed a minimumm of 300 hundred hours to the SBTF fund within 24 months of the date of this application?

If you haven't contributed 300 hours explain why.

Student Information

Name(Required)

First Last

S.I.N(Required)

Address(Required)

Street Address Address Line 2 City Province Postal Code

Phone(Required)

Email(Required)

Birth Date(Required)

Name of University / College(Required)

Faculty / Program(Required)

Student Number(Required)

School Start Date for Year(Required)

School End Date For Year(Required)

Year of Program Attended(Required)

Length of Program(Required)

Did you obtain a passing grade and complete the year?(Required)

If no explain why:

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Office Use Only

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Members Dues Paid To:

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Date of Good Standing:

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Application Approved Y / N

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Reason For Denial

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Fall

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Winter

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Total Tuition Paid

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Spring

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Summer

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Calculation

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Ends Entitlement Y / N

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Maximum Amount Y / N

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Approved Amount

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Date Recieved

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Date Approved

Student's Birth Certificate(Required)

Max. file size: 50 MB.

Official Transcript of Term Marks(Required)

Max. file size: 50 MB.

Proof of Completion

Max. file size: 50 MB.

Tuition Confirmation Form(Required)

Max. file size: 50 MB.