Nominee Information
Nominee First Name:
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Nominee Last Name:
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Nominee Mobile:
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Nominee Email:
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City:
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Campus Preference:
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Campus Preference:*
Edmonton
Winnipeg
Instructor/Teacher Information
Instructor/Teacher Name:
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Instructor/Teacher Email:
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High School Name:
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Academic Information
Reason for Scholarship Nomination
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Course Average to Date
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Absences First Semester
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Absences Second Semester
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