Application Form for Student Volunteer Education Bursary

The Student Volunteer Education Bursary is a financial grant of up to $1,000, awarded annually by Volunteer Services to Hotel Dieu Hospital (HDH) Site, to an eligible student volunteer at the HDH site of Kingston Health Sciences Centre.  The funds will enable the volunteer to continue his or her studies at a post-secondary institution in the health care field, services and/or setting.


  • You are a dedicated, enthusiastic and active student volunteer at the HDH site and have volunteered for one academic year.
  • You uphold HDH’s mission and values.
  • You have consistently attended (at least 90%) and performed well in your volunteer duties.


Please contact Joan Carstairs at or 613.544.3400, ext. 2312.


Complete the form below and submit it on or before February 28, 2019.


Applicant Information

If different from above.

Educational Opportunity Requesting Support For

And major if applicable.

Please provide the following information


All applications will be held in strictest confidence. The Student Volunteer Education Bursary committee of Volunteer Services to HDH reserves the right to request reference(s) from an applicant, to review KHSC’s Volunteer Services department data records and/or request an interview from prospective applicants, if additional information is required.

  • I have demonstrated a high level of consistency in attendance (at least 90%) throughout my volunteer service at HDH site.
  • I understand that as a successful candidate, my name, the amount awarded and my planned course of study may be included in the newsletters published by KHSC Volunteer Services department and Volunteer Services to HDH and on KHSC intranet website.
  • In the event I am not able to complete the planned course/program of study and/or have used the Bursary funds for expenses other than educational expenses such as tuition, registration fee(s) or books, the agreed upon Bursary award will be immediately returned to Volunteer Services to HDH.
  • Once I have completed my course or program, I will submit a short report to Volunteer Services to HDH, highlighting how the course is of benefit to me and how it is leading to my career pursuits.
Type your full name above to act as your signature.