Apply for the Momentum Indigenous Scholarship

Step 1 of 8 - Contact Info

Personal Information

Your Name*

First Last

Date of Birth*

Phone*

Email*

Current Address*

Street Address City Province Postal Code

Membership in which Indigenous Community*

Other Indigenous Community*

Please enter the name of your Indigenous Community

Front of Indigenous Card*

Please attach a photo of the front of your Indigenous card

Accepted file types: jpg, png, Max. file size: 10 MB.

Back of Indigenous Card*

Please attach a photo of the back of your Indigenous card

Accepted file types: jpg, png, Max. file size: 10 MB.

Required Consent*

I am over 17

I agree to provide signed consent from my parent or legal guardian when requested

Reference Information

*Reference forms will be submitted separately online, by fax or email. Reference forms will be accepted at any time up to the application deadline of Midnight MST on Friday, June 16, 2023.

- References should not be a friend or relative
- Please consider one academic and one character reference

Name of Reference 1

Prefix First Last

Reference 1 Phone

Reference 1 Email

Please provide an email address for your reference if possible. We'll send them an automatic notification that you've applied for a Momentum Scholarship, along with a link to the Reference Form.

Name of Reference 2

Prefix First Last

Reference 2 Phone

Reference 2 Email

Please provide an email address for your reference if possible. We'll send them an automatic notification that you've applied for a Momentum Scholarship, along with a link to the Reference Form.

How did you hear about the Strathcona Resources Spark Award? (Please choose one)*

Community group/member

My school

Social media

Strathcona employee

Other

Declaration and Consent

To proceed with your application, you must read and consent to the direct and indirect collection of your personal information, the use and disclosure of your personal information, as well as the terms and conditions set out below. Applicants under the age of 18 must also obtain the consent of their parent/guardian.

I agree that:*

Type Your Full Name*

Date*

The date you completed this application

Name

This field is for validation purposes and should be left unchanged.