Student Bursary Application

Name of student

Name of parent (must be a Dartmouth Local NSTU member)

Six digit professional number (of parent)

Parent's school/site

Parent's mailing address including postal code

Parent's preferred phone number

Parent's preferred email address

Name of post-secondary institution (that son/daughter will be attending)

Name of program

Length of program (years)

Have you ever received a student bursary from Dartmouth Local NSTU (Yes/No)

I have read and understand the guidelines posted on the Dartmouth Local website (confirm by typing "Yes")