Burlington Girls Hockey Club

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Scholarship Application

Name: 
Phone:
Address:
E-Mail
Address: 
Current Team  
Coach's Name  
Current High School  
Graduating Date:  
Post-Secondary Institution you will be attending  

Identify the ways you meet the selection criteria.  If there is not enough space, please send an essay on how you meet the criteria to our mail box to the attention of the Scholarship Committee.