SouthEastern Mutual Scholarship Fund - Application Form - South Eastern MutualSouth Eastern Mutual

SouthEastern Mutual Scholarship Fund – Application Form

SouthEastern Mutual Insurance Company provides a special benefit to policyholders. Each year since 2002, the company has offered $6,000 in scholarships to policyholders and/or their dependents. Previously, the funds were allotted in twelve $500 scholarships. In 2017, we are offering six $1,000 scholarships. Education is costly and the Company is pleased to help offset the high cost of post-secondary education.

Complete this application form and get started on your future!!

General Requirements of Eligibility

The Applicant (or parent/guardian) must be a SouthEastern Mutual policyholder.

The Applicant must complete an approved application form.

The Applicant must show proof of acceptance or enrollment as a full time student at a post secondary educational institution (college or university).

The Applicant may choose to submit a 30-60 second video or audio recording on the choice of 2 topics: SouthEastern Mutuals Present Day Company, or The History of SouthEastern Mutual.

Successful Applicants must provide a recent colour photo to the Company for publication.

The Applicant must not have received any scholarship monies from SouthEastern Mutual prior to this submission. (Applicants may receive only one scholarship from SouthEastern Mutual.)

The Applicant must return the application form no later than 4:30 pm on May 15th to:

SouthEastern Mutual Insurance Company
Scholarship Selection Committee
663 Pinewood Road
Riverview NB E1B 5R6

Selection Process:

There will be four draws from each County for a total of twelve Scholarships each year. Applicants must have fully completed an approved application form and have submitted it to the office of SouthEastern Mutual by the required time and date specified above. SouthEastern Mutual will notify successful applicants by June 10th. Before issuing cheques on November 10th of the same year, the company will require successful applicants to provide proof of registration in a post-secondary institution. A copy of the paid tuition, a letter from the school or institution, or a photocopy of the student card are all examples of acceptable proofs of registration.

Application Form

Title*
Name*
First Last
Address*
Street Address Address Line 2 City Province Postal Code
Phone*
Alternate Phone
Email*
Date of Birth*
MM
DD
YYYY
SouthEastern Mutual Policy Number*
Relationship to Insured*
Name of School/College/University attended in the past year
Address of School/College/University attended in the past year
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Name of Institution you plan to attend*
Address of Instituion you plan to attend*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Declaration of Applicant*
- I agree
- I disagree
I do solemnly declare to the best of my knowledge and belief the information supplied above is correct and complete in every respect, and that any monies issued will be used only for valid educational purposes.

SouthEastern Mutual Scholarship Fund – Application Form

General Requirements of Eligibility

Selection Process:

Step 1 of 2

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