BACH Foundation Bursary Application Form Applicant Information Name * First Name Last Name Phone * (###) ### #### Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Email * Educational Information Year graduated from Caledonia Regional High School: * Educational Institution Enrolled: * Educational Institution Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Program of Study: * Program Duration: * Tuition Fee: * In the space provided below, please explain how your enrollment in this post-secondary program will contribute to you achieving your life goals. The Bennett and Albert County Health Care Foundation's vision is to have a positive impact on the health and wellness for the people served by the Albert County Community Health Centre with the support of our community. In the space provided below, explain how your participation in this educational program will contribute to improving the health and wellness of individuals. Clicking the submit button below serves as my electronic signature on this application. Thank you for your application! It will be reviewed according to our Bursary Policy.