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2015W - Premier Wesbrook - Application Form
2015W - Premier Wesbrook - Application Form
APPLICATION INSTRUCTIONS:
In order to qualify, Wesbrook Scholar and Premier Undergraduate Scholarship candidates must be nominated
by an eligible nominating body. As such, this application requires sections to be completed by the candidate
as well as the Faculty or School.
1. This application is for students registered in a degree program at the Vancouver Campus.
2. Please complete all parts of this application in black ink.
3. The candidate must submit all sections of Part B: Candidate Documentation to their Faculty or School (not
Department). The Faculty or School must complete the Ranking and Endorsement (Part A, Section 2), and
determine if the candidate is in the top 10% of their year. Students must be endorsed by their Faculty or
School and only those nominations will be forwarded to the Selection Committee.
4. Completed packages must be received by Enrolment Services at the above address by 3:00 PM, Friday
October 23rd, 2015.
5. Incomplete, faxed or electronic applications will NOT be considered.
6. Interviews of finalist candidates will take place in January 2016.
7. Successful candidates will be notified by late January 2016.
Note:
UBC students who were studying abroad during the previous winter session must submit transcripts
from the exchange institution with this application (photocopies are acceptable)
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Enrolment Services
1874 East Mall
Vancouver BC V6T 1Z1
Phone: 604-822-9836
financial.support@askme.ubc.ca
Have attended UBC for at least two full previous winter sessions (2013/14 and 2014/15) as a full-time
student (see definition on page 1);
Rank academically in the top 10% of their year and Faculty;
Have entered the penultimate or final year of a baccalaureate program, or any year of J.D., M.D. or D.M.D.
programs;
Have demonstrated the ability to work with and lead others; as well as participating in student and
community activities; and
Be nominated by their Faculty or School.
Premier Undergraduate Scholarship candidates are subject to the following additional criteria:
Note: Applications do not need to specify for which set of scholarships a student is being nominated. Enrolment
Services will ensure that candidates are considered for all scholarships for which they are eligible.
ARE YOU A PREVIOUS RECIPIENT?
Candidates who have previously received a Wesbrook Scholar designation and/or Premier Undergraduate
scholarship are ineligible to receive the Wesbrook Scholar designation again but may be considered for a
Premier Undergraduate Scholarship. When assessing eligibility, the Committee will primarily consider the
candidates accomplishments and activities since receiving the Wesbrook Scholar designation and/or Premier
Undergraduate scholarship.
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Enrolment Services
1874 East Mall
Vancouver BC V6T 1Z1
Phone: 604-822-9836
financial.support@askme.ubc.ca
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Enrolment Services
1874 East Mall
Vancouver BC V6T 1Z1
Phone: 604-822-9836
financial.support@askme.ubc.ca
NOMINEE DOCUMENTATION
out of
in year
of
(Faculty or School Not Department)
Name (Print)
Title
Signature
Date
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Enrolment Services
1874 East Mall
Vancouver BC V6T 1Z1
Phone: 604-822-9836
financial.support@askme.ubc.ca
CANDIDATE DOCUMENTATION
* Dates should include the month, year and if applicable, hours per week (e.g. Feb 2012 to Aug 2013; 3 hours
per week)
5. REFERENCE LETTERS
Please include two confidential letters of recommendation as follows:
o
o
Reference letters are intended to support a candidates eligibility and should reference all related award
criteria, such as the candidates demonstrated ability to serve, work with and lead others.
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Enrolment Services
1874 East Mall
Vancouver BC V6T 1Z1
Phone: 604-822-9836
financial.support@askme.ubc.ca
DECLARATION
Pursuant to the Freedom of Information and Protection of Privacy Act, I hereby give my consent to Student
Financial Assistance and Awards at the University of British Columbia to release my personal and academic
information to award donors, University Faculty, University administrative staff, through University and other
publications (including appropriate UBC websites), and in associated ceremonies and events, and the Selection
Committee Members.
I hereby declare that the information in this nomination package (including the personal statement and
statement of activities) is accurate and complete. I understand that UBC retains the right to verify information
on my application.
Date (YYYY/MM/DD)
Signature
ABORIGINAL BACKGROUND
One of the awards considers a students aboriginal heritage. If you wish to be considered for this award,
please self-identify by selecting one of the following options:
First Nations
Mtis
Inuit
Not applicable
PART C:
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Enrolment Services
1874 East Mall
Vancouver BC V6T 1Z1
Phone: 604-822-9836
financial.support@askme.ubc.ca
Date (YYYY/MM/DD)
Signature
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