The Remember Jordan Scholarship was established in remembrance of 18-year-old Jordan Roppel, who passed away in 2004 after being struck by the shank of a trailer ball during a summer job. In recognition of the danger associated with shock loading arising from improper training or equipment, PSAC Affiliate member, Ditch Hitch, worked with PSAC to establish the Remember Jordan campaign to raise awareness of the dangers of shock load vehicle recovery.

Applicants must complete all the fields in the application and meet the eligibility criteria in order to be considered.

* 1. Contact Information

* 3. Have you received a PSAC scholarship in the past?

Applicant Background Information

* 4. Will you be 25 years of age or younger on June 30, 2018?
Were you born on or after June 30, 1993 ?

* 5. Are you a Canadian citizen?

* 6. PSAC Core Member company contact information

Academic Information

* 7. Please indicate your current or expected level of post-secondary study:

* 8. Please specify the institution you plan to or will be attending (must be an accredited post-secondary Canadian institution):

* 9. Are you registered or planning to register in a business, engineering, health & safety or trades/apprenticeship program in Canada?

* 10. Please indicate the specific academic program you are or will be registered in:

* 11. What is your expected date of registration in your post-secondary program (month/year)?
NOTE: if you are already enrolled in your post-secondary program, please indicate the month/year in which you started your studies

* 12. What is your cumulative GPA / average mark for your most recent school year (post-secondary or high school)?

* 13. When do you expect to complete / graduate from your post-secondary program (month/year)?

* 14. Do you plan to work in the petroleum services sector after graduating from your post-secondary program?

Leadership and Community Involvement

* 15. Describe leadership roles you have fulfilled including those in school, sports etc., and your community involvement including extra curricular and volunteer activities. (250 words maximum)

* 16. Briefly describe your knowledge of the oil and gas industry in Canada. (250 words maximum)

* 17. Why do you believe you are a worthy candidate to receive this scholarship? (250 words maximum)

Declarations and Consent

* 18. I declare that I have read, understood and complied with all the rules and regulations related to the contest; and that I have provided all information required from me and that all information provided by me to PSAC in all respects is true and accurate.

* 19. I consent to the collection, use and disclosure of any or all of my name, my city of residence, my photograph, my voice and my image for publicity and programming purposes, commercial or otherwise, in all media used by PSAC and its respective advertising and promotional agencies with respect to the contest, without payment or compensation, notice or approval, throughout the world for so long as required by PSAC including its successors and assigns.

* 20. I understand that the personal information that I provide voluntarily in my application to the PSAC Member Scholarship program will only be used by PSAC staff and members of the PSAC Education Fund Committee to determine my eligibility for a scholarship.  The personal information that I provide will not be disclosed, made available or otherwise used for purposes other than specified here, except with my expliicit consent.  The personal information I provide will be protected by reasonable security safeguards against such risks as loss or unauthorized access, use, or modification or disclosure of data.

* 21. Date and Name

Thank you for applying for the 2018 PSAC Remember Jordan Scholarship Funded by Ditch Hitch.