Step 1 of 3 33% Name First Middle Last Date of Birth MM slash DD slash YYYY Street Address Street Address Address Line 2 City AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Province Postal Code Home Phone NumberCell Phone NumberEmail Are you a Canadian Citizen or Permanent Resident? Yes No Community Arts BriefAccepted file types: doc, docx, txt, pdf, Max. file size: 10 MB.Attach a one-page brief detailing why you feel the arts are important to our community and how you feel you can make a differenceConsent(Required) I agree.I hereby submit my application for the Laurie Pallett/Metalworks Institute Scholarship and declare that the information on this form is complete and true to the best of my knowledge. Upon email submission, I authorize the release of the information contained in this application to those parties involved with the selection of the successful recipient of this scholarship. Δ Please Note: Incomplete applications will not be considered. The successful recipient will be notified of the award outcome. The scholarship holds no cash value.