YOUTH BURSARY APPLICATION (Please ensure registration for the Expedition has been completed first)
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Last Name:
First Name:
Middle Name:
Date of Birth:
Age:
Gender:
M
F
Nationality:
Bermudian
Other
If non-Bermudian:
School (Or Employer):
Mailing Address (house no., street, parish & postal code):
Home Phone:
Personal Cell Phone - if applicable:
Personal Email:
PARENT/GUARDIAN INFORMATION (IF APPROPRIATE)
1. Parent/Guardian (primary contact)
Name:
Relationship to Participant:
Work Phone:
Home Phone:
Cell Phone:
Email:
Physical Address:
2. Parent/Guardian (secondary/support)
Name:
Relationship to Participant:
Work Phone:
Home Phone:
Cell Phone:
Email:
NOTE THAT ALL INFORMATION IS HELD IN STRICT CONFIDENCE AND ONLY USED FOR THE PURPOSE OF THIS APPLICATION.
Please indicate the name and dates of the voyage or programme intended
Please describe household income (MUST INCLUDE monthly income and no. of working adults who contribute to the household where youth resides)
Outside of those in this household, is there any other adult contributing to the support of this youth? If so, how much per month (i.e., child support, or other monetary contributions)
Please provide all info on living situation (rent or mortgage?) with monthly expenditures by area (i.e, rent/mortgage $ Belco, $ phone, $ cable, $ food, $ car payments (w/type of vehicle), $ ALL other expenses-please list and detail, including travel and other personal expenses engaged in this year or planning on, etc.
Please indicate your household occupants (#adults & #children (with ages)
Are you and/or the applicant willing to assist BSF/Spirit of Bermuda by volunteering if requested?
How much can you & your child contribute towards the voyage cost?
What can /will your young person (however small) do to contribute towards the voyage cost & how much will he/she commit to? (examples: pledge sheets, pack groceries, etc.)
Please use this space for any other information you would like us to know that would help us evaluate this application, such as previous Spirit involvement, goals for participation, etc. Information such as previous experiences, changes observed, why he/she wants to do this expedition, goals, etc. Send more by email on separate cover if needed.
Contact Information