Rutherford Achievement Scholarship

Personal Information Alberta Student Number – available in the “Inquiry” tab in SIS or from Career Centre staff High School Code-0017 Social Insurance Number –if you do not have a social insurance number apply

Proposed Post-Secondary Studies Name the institution that you plan on attending in the fall ( if you are applying to more than one, list your first choice) Institution codes are located on the back page. Example:MacEwan 2247,NAIT 2221,University of Alberta 2201

Secondary Education Name of High School -** Centre High Campus** (not the high school you attended before coming to Centre High)

Declaration of Applicant Make sure to sign the application * IN INK Make sure to date the application

Important Information Apply by May 1st for post secondary starting September Apply by December 1 st for post secondary in January Mail to Alberta Scholarship Programs at Box Station Main Edmonton. Alberta T5J 4R4 or deliver to 4 th Floor, street Edmonton,AlbertaT5K 2V1

If you decide not to attend post secondary, after you have applied for the scholarship Notify Alberta Scholarship Board that you are not attending for the year you have applied. The phone number is on the application or available from the Career Centre. If you do not let them know, you could forfeit your scholarship.