SIGMA CHI CANADIAN FOUNDATION JOHN W. GRAHAM SCHOLARSHIP GENERAL INFORMATION Full Name Permanent Address (street, city, province, postal code; NOTE: there must be somebody at this address in October of this year able to receive the scholarship cheque) School Address (street, city, province, postal code) Summer Phone Number E-mail Address (required) S.I.N.: (required - feel free to enter 'xxx' and when required, we will reach out directly.) LETTERS OF RECOMMENDATION Name: Please upload letter of recommendation : Relationship Name: Please upload letter of recommendation : Relationship ACADEMIC INFORMATION Please Upload Copy of Full Academic Transcript (All Terms): University Attending in the Fall Program Planned Year of Graduation Post-Secondary Degrees Already Achieved SIGMA CHI HISTORY Chapter Date of Initiation List the Offices you have held in Sigma Chi: LEADERSHIP EXPERIENCE Please list your activities outside of Sigma Chi in which you are/have been involved. You are encouraged to outline some of your accomplishments from these activities. HONOURS & AWARDS Please list any Honours & Awards you have received, including a short description of the Honour or Award. I certify that all information provided in this form is true. Date