CAMBRIDGE INTERNATIONAL ACADEMY

SCHOLARSHIP PROGRAM

Scholarship Application Form

Applicant Information

First name

Middle Name

Last name

Address

Home Phone Number

Alternate Phone Number

Birthday

Current Grade

Single choice

Male

Female

Other

Primary e-mail address of applicant’s family

Parent #1 first name

Parent #1 last name

Parent #2 first name

Parent #2 last name

Current School Information

Name of School

Address

Country

Date of enrollment

Language of instruction

Academic Achievements

Completed AP Courses:

Score:

Completed AP Courses:

Score:

Completed AP Courses:

Score:

Completed AP Courses:

Score:

Completed AP Courses:

Score:

Language Assessment Score:

Academic Contests

Math:

Physics:

Chemistry:

Biology:

Business:

Social Sciences:

Athletics, Arts and/or Community Involvement

Demonstrated Service Leadership

Written Reflective Piece

Please tell us about how you have made a positive impact on your current school community.

Scholarship Application Checklist

Please review the following scholarship application checklist to ensure that all required documentation has been submitted in order to be

considered for the Cambridge International Academy Scholarship:

Cambridge International Academy application for admission and all required supporting documents

Completed Cambridge International Academy Scholarship Application form

A LETTER OF REFERENCE, sent directly to Cambridge International Academy, that speaks to your achievements and character.

Note - This is separate from your confidential teacher report submitted with your application. The letter should clearly indicate your name and that it is

related to your scholarship application.

Applicant Signature

Date (DD/MM/YYYY)

Parent Signature #1

Date (DD/MM/YYYY)

Parent Signature #2

Date (DD/MM/YYYY)

(905) 426 - 4254

info@cambridgeinternationalacademy.ca

CAMBRIDGE INTERNATIONAL ACADEMY

SCHOLARSHIP PROGRAM