MindFuel Scholarships for Post-Secondary

STEM (Science, Technology, Engineering, Math) and Science

Education Based Learning Programs
Scholarships are available to students who have graduated from an Alberta high
school and who are entering first year in an undergraduate applied science or
science education program at an Alberta-based post-secondary institution in the
fall 2015.

General Information and Policies

MindFuel offers three scholarships to students applying to an Alberta-based post-secondary institution.
Value: $2,500 - $5,000
Criteria

Applicant must be an Alberta high school graduate.

Applicant can apply for more than one scholarship, however, upon successful selection, would only be
eligible to receive one scholarship award.
Eligibility: Open to students entering first year in an undergraduate science, applied science degree or
science education program at an Alberta-based post-secondary institution in fall 2015.
Application: Available January 20, 2015.
There is one deadline for the competition:
DEADLINE: May 15, 2015 for entering the College, Polytechnic, or University in the 2015/2016 program
year.
Notification: Recipients are notified by phone or email on June 22, 2015. Recipients are not required to
accept their award, but must notify MindFuel by June 26, 2015 regarding their acceptance or decline of
award.
Registration Requirement(s): Recipients are required to be registered full-time at an Alberta-based postsecondary institution for the fall term by August 15, 2015 and must maintain full-time enrolment through
the upcoming fall and winter terms.
Payment: Award funds are sent to the registrar and are automatically applied to outstanding tuition and
fees.
1.

2015 Application Form

Important Application Checklist
Before mailing your application, ensure that it
contains all the required documents in the
following order:
1. this application form, fully completed and
signed;
2. your essay of up to 500 words, by you,
describing your interest in STEM (Science,
Technology, Engineering, and Math) or
Science Education based on the scholarship
you are interested in applying for. Tell us:
which of our three scholarships you
are applying for and why.
why you are interested in pursuing a
science or education based learning
program. Why are you passionate
about the program of studies you
are pursuing?
how could you apply your education
in innovative ways?
how STEM has affected you?
3. an original letter of recommendation from
your school, written and signed (electronic
signatures will not be accepted) by a senior
official, such as your principal, guidance
counsellor or teacher;
4. two letters of support or confirmation
written and signed (electronic signatures will
not be accepted) from groups or individuals
(e.g. mentor, volunteer program, employer,
etc.) who have influenced you, and on which
this application is based. If there are
exceptional circumstances where these two
letters cannot be provided, you may include
a letter detailing those special
circumstances;
5. official copy of high school transcript;
6. any additional facts about you that have
not been identified in the outlined
requirements, that you feel we should be
aware of. Please include in written form, in
fewer than 200 words.
2.

No material, other than that listed on this page,

will be presented to the Awards Committee.
Materials cannot be returned. Please retain a copy
of this application for your records.
Applicants selected as award recipients will be
notified by June 22, 2015 by phone or email.
Additional written notification will be sent to
award recipients by June 22, 2015. Scholarships
will be awarded at a ceremony in mid-July.
Applicants who are not awarded a scholarship will
be notified by end of June 2015.
All applications and correspondence should be
sent by registered mail or courier to:
MindFuel Scholarships Program
Suite 260, 3512 33 Street NW
Calgary, Alberta T2L 2A6

Deadline
All applications and supporting documents must
be received no later than Ma y 15 , 2015. No
applications will be accepted after the deadline
regardless of the postmark date. Please do not
send applications by fax or email, as they will not
be considered. This application MUST be filled out
and sent by MAIL or COURIER.

For more information:

MindFuel
403-220-0077 ext. 238 or
Scholarship@MindFuel.ca

Tell Us About Yourself

All fields are required
Ms.

Citizenship

Mr.

Canadian Citizen

First Name

Christian

Last Name

Merrill

Karl
Apt.

Telephone

n/a

City
Calgary

Other (Please Specify)

Middle Name

Home Address

1165 Wentworth View SW

Permanent Resident

403-614-2544

Province

Postal Code

Alberta

T3H 5K3

Email (required in order to confirm receipt of application)

Expected date of graduation

christian.merrill.cm@gmail.com

06/30/2013
M / D / YYYY

Name of High School

Ernest Manning High School

School Address

Telephone

403-249-3131

20 Springborough Blvd SW
City

Calgary

Province

Postal Code

Alberta

Fax

T3H 0N7

403-777-7839

Any previous high schools attended, by year

Yes

Are you currently completing the final year of high school in Alberta

No

Career/Occupational Interests
List up to three careers or occupations you are considering. If you dont know yet, indicate
uncertain.

1. Bio-medical engineer
2. Nuclear Energy
3. Other alternitive energy sources/research

Educational Intentions After High School

If known, name of educational institution you plan to attend.

Type of institution (circle one):

University

University of Calgary
Anticipated course of study and degree/diploma sought.

College

Have you received early acceptance?

yes

Engineering (type, unsure)

Polytechnic

no

Anticipated start date.

If yes, which school(s) has accepted you?

September 2015

University of Calgary
3.

James (Jim) Gray Scholarship - $5,000

Note: The successful recipient of this scholarship must be entering an area of STEM
(Science, Technology, Engineering or Math) related study at an Alberta -based postsecondary institution.

Must be completed
Complete your 500-word essay describing your i n t e r e s t i n i n n o v a t i o n a n d t h e a r e a s o f S T E M
( S c i e n c e , T e c h n o l o g y , E n g i n e e r i n g , a n d M a t h ) . Then, in the space below, SUMMARIZE your
most important achievement to date in this area in a few sentences.

Anne Tingle Scholarship - $2,500

Note: The successful recipient of this scholarship recognizes an individual who is
passionate about science and who is accepted into an undergraduate degree
program in either science or science education at an Alberta -based post-secondary
institution.
Must be completed
Complete your 500-word essay describing your i n t e r e s t i n s c i e n c e o r s c i e n c e e d u c a t i o n . Then,
in the space below, SUMMARIZE your most important achievement to date in this area in a few
sentences.

Dr. Arlene Ponting Scholarship - $2,500

Note: The successful recipient of this scholarship recognizes an individual who is
passionate about science and technology and who is accepted into an
undergraduate degree program in either science or technology at an Alberta based post-secondary institution.
Must be completed
Complete your 500-word essay describing your i n t e r e s t i n s c i e n c e a n d t e c h n o l o g y . T hen, in the
space below, SUMMARIZE your most important achievement in this area to date in a few sentences.

4.

List organizations and/or individuals whose letters of support/confirmation, regarding the

above, are enclosed with this application.
Name of Individual

Organization

Daytime Phone Number

1.
2.
List name and title of senior official from your school whose letter of recommendation is
enclosed with this application.
Name

Title

School

Extracurricular Activities
List extracurricular activities in which you have participated, if any, and specify the nature of
your involvement in each.
Activity

1. Youth Group

Role
Youth group leader

Hours Contributed

Year(s)

570

2007-12

2.
3.

Work Experience/Volunteer Experience

List part-time jobs or volunteer opportunities you have held, if any, specifying employer,
type of work and length of time in position.
Employer

1.

Canada Olympic Park/ Winsport

Type of Work

Hours Contributed

Year(s)

Volunteer Bike instructor

160

2009-10

2. Good Neighbor Yard Services

Snow Removal

200

2011-13

3. Good Neighbor Yard Services

Yard care and Landscaping

750

2011-13

If there are facts about you that have not been identified in the outlined requirements that
you feel we should be aware of, please include this information.

5.

Terms and Conditions

1.

2.
3.

4.

5.

6.

MindFuel reserves the right, in its sole discretion, to modify, amend or cancel
the MindFuel Scholarships Program (the Program) at any time without
notice, and to decide all questions respecting the awarding of Scholarships, and
the administration of the terms and conditions of the Program.
The following persons are NOT eligible to receive a Scholarship: employees of
MindFuel; the children of MindFuel employees; and Program applicants
(Applicants) who provide false information to MindFuel at any time.
To be eligible for a Scholarship, Applicants must:
a) Be an Alberta high school graduate or graduating in 2015 from an Alberta high
school.
b) Be Canadian citizens or have permanent resident status
c) Certify that all the information provided on the Program application form
(Application) and in all the accompanying documents is true, accurate and
complete to the best of their knowledge.
By submitting an Application, the Applicant authorizes MindFuel, the
Scholarship judges, The Association of Universities, Polytechnic and Colleges of
Alberta, and their respective representatives to collect, use, store and confirm
information about the Applicant, provided on the Application submitted
(including references) to those who need to know such information for the
purposes of administering and promoting the Program. The selection
committee will use the information only for the purposes of evaluating the
Application.
A Scholarship awarded under the Program can be only be used at any college,
polytechnic or university in Alberta. The Scholarship recipient (Recipient) is
responsible for securing admission to an approved school of their choice, in
accordance with the requirements and deadlines of each school.
The MindFuel Scholarships Program:
a) Award funds will be sent to the Registrar after official transcript
cconfirmation of full-time enrollment in post-secondary studies is provided by
the student from their approved school to MindFuel

b) Reserve the right to publish and/or disseminate information regarding its scholarship

winners including students name and photos.

The Recipients must:
a) Attend an approved school on a full-time basis (as defined by the school)
b) Be enrolled in a course of study leading to an undergraduate science, applied
science or science education degree/diploma.
8. A Scholarship may be terminated at any time by MindFuel, upon the occurrence
of any behavior on the part of the Recipient, that MindFuel, in its sole
discretion, deems inappropriate.,
9. All Recipients must inform themselves as to the tax consequences of receiving the
Scholarship.
10. All Recipients will be required to sign a Declaration and Release which will
entitle MindFuel to use the Recipients name, city and province of residence,
and photograph, without further compensation for any publicity carried out by
MindFuel with respect to the Program.
11. MindFuel will establish an alumni network for recipients of the MindFuel
Scholarships (the MindFuel Scholars Alumni Network). You will automatically
join the MindFuel Scholars Alumni Network. Membership in the MindFuel
Scholars Alumni Network includes but is not limited to: invitations to MindFuel
events; participation on MindFuel Scholarship advisory councils; and invitations to
join MindFuel Scholarship social groups. You may terminate your participation in
the MindFuel Scholars Alumni Network at any time by notifying:
Scholarship@MindFuel.ca MindFuel Suite 260, 3512 33 Street NW. Calgary,
Alberta T2T 1T7.
12. Membership in the MindFuel Scholars Alumni Network may be terminated at
any time by MindFuel, upon the occurrence of any behavior on the part of an
alumnus that MindFuel, in its sole discretion, deems inappropriate.
7.

Acknowledgement and Authorization

I understand that the information submitted in and with this application will be used to assess my eligibility for the scholarship. I certify that all the information provided on this
application form and in all the documents accompanying it is true, accurate, and complete. I have read all the Terms and Conditions as listed above. By submitting this application, I
agree to be bound by all these Terms and Conditions.

Signature

Date

If under 18 years of age, a signature of parent or legal guardian is required.

Signature

Date

Name (printed)

Please take a moment to answer the following question to help us improve the
program.
How did you hear about the MindFuel Scholarships for Post-Secondary STEM and Science Education
Based Learning Programs?
a. Family/Friend
c. Internet
e. Email

b. Facebook
d. School/Teacher
f. Twitter
6.