First Name
*
Your first or preferred name
Last Name
*
Your last or family name
Student Number
*
Enter your Humber student number
Campus
*
Select your campus
North
Lakeshore
Guelph-Humber
Orangeville
Gender
Preferred Gender Pronoun
DOB
*
Enter your date of birth
Phone Number
*
Enter your phone number
Email Address
*
Enter your email address
Address Line 1
*
Street address, P.O Box
Address Line 2
Apartment, suite, unit, floor, etc.
City
*
Postal Code
*
Province
*
Please list 5 facts about you that will help us better understand who you are.
*
As a Black/African student, what has been your experience on-campus so far?
*
What are you hoping this next chapter in your educational journey will be?
Describe your past or present community or volunteer involvement.
*
Feel free to also share what type of community or volunteer work you would like to do in the future.
Please provide an example of a time when you exemplified IGNITE's values and showed leadership skill
*
Commitment to Safety, Communication, Critical Thinking, Integrity & Trust, Leadership, Planning
What ways will this scholarship continue to help you be a leader of Black Excellence on campus?
*
Resume
*
(Accepted Formats .doc, .docx, .pdf) Max Size 5MB