Anita Binnie Award Form

Applicant's Name *

First

Last

Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Phone

Email *

Secondary School

College or University to be attended next year or Training Program to attend

Discipline/Program being studied or Training Program

Acceptance Guaranteed

Your ultimate career aim

Please upload a letter of recommendation from a teacher or academic counsellor

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Please upload a letter of recommendation from a performing arts instructor

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Please upload a one page letter about yourself and why you want to pursue a career in the arts

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Confirmation

I agree to submit the required report to the QAC within the designated timeframe.