Elwood Harvey Co-operative Leadership Program

First Name

Last Name

Preferred Name (if different)

Providing this information helps our employees address you appropriately.

Pronouns

Cell Phone

Home Phone

Mailing Address

City/Town

You must reside in Saskatchewan to apply.

Postal Code

Email Address

All contact and information from Affinity will be sent to this email

Do you self-declare with an Indigenous group? (Optional)

Yes No

What First Nations band or Indigenous community (if any) do you identify with? (Optional)

Do you want your application to be considered by the Indigenous Member Council as opposed to the geographical district based on your postal code?

Yes No

Must be a member or a dependant of a member to receive award. Visit your local advice centre to open an account with Affinity!

Are you a member of Affinity Credit Union?

Either you or your parent(s) need to be an Affinity member to apply and bonus points are given if you’re both members.

Student's Affinity Credit Union Member Card or Account Number

Please check if the account number/member card number is correct.

Are your parent(s) a member of Affinity Credit Union?

Parent's Name

Parent's Affinity Credit Union Member Card or Account Number

Please check if the account number/member card number is correct.

Nearest Affinity Credit Union Advice Centre

School Name

School Mailing Address

School Contact

Principal, Guidance Counselor, Secretary

School Phone Number

School Contact Email Address

This will be used to contact the school about the awards presentation in your Grade 12 year.

My grade 10 academic average was:

Once you've completed this application, you'll be asked to upload your high school report card or transcript with your grade 10 marks.

Reference

References cannot be a relative. Reference letter must answer the following questions:

Tell us about the student's personal qualities
Tell us about the student's contributions to their community and school
Why should this student receive this award?

Reference Name

Reference Phone

Relationship to Reference

Years Known

Once you've completed this application, you will be asked to upload a reference letter as a supporting document.

High School Involvement

Describe your involvement in high school activities (E.g. student council, athletics, music/ art/drama, clubs, tutoring, leadership positions, etc.).

When indicating your time please include how many hours you were involved, how often and whether it was paid or volunteer time.

Activity (ex. Yearbook Committee)	Time (ex. 2 hours per week for 6 months, volunteer)	Involvement	Role

Community Involvement

Are you or your family a member of a co-operative or involved in co-operative activities?

Yes No

e.g. participated in Camp Kindling (SK Co-op Youth Camp Retreat); member of a local co-op

List and describe your involvement in community activities over this past year (i.e. volunteer work, coaching, organizations /clubs/ athletics outside of school, any leadership positions, work experience, church, etc.) and total the hours.

When indicating your time please include how many hours you were involved, how often and whether it was paid or volunteer time.

Activity (ex. Meals on Wheels)	Time (ex. 2 hours per week for 6 months, volunteer)	Involvement	Role

Personal Development

Describe any activities that you’ve chosen to participate in to improve your personal awareness, develop personal talents and employability (E.g. First Aid, additional training or courses, coaching, piano lessons, etc.)

When indicating your time please include how many hours you were involved and how often.

Activity	Time (ex. 2 hours per week for 6 months)	Involvement	Role

Please choose one essay option. Essay is a maximum of 400 words.

Option 1: Describe your vision for the kind of community you would like to live in.

Briefly describe two projects (real or potential), with one being a co-operative, that would contribute to this vision.
How would the co-operative principles and values contribute to this vision?

Option 2: In your own words, provide a brief history of any co-operative in your community.

What role does (or did) it play in contributing to the well-being of your community?
How did it incorporate the co-operative values and principles in its daily functioning?

Select Submit to send in your application. You'll be asked on the next page to provide your supporting documents. If you encounter any issues, email leadershipaward@affinitycu.ca.

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Elwood Harvey Co-operative Leadership Program 2025

Reference

High School Involvement

Community Involvement

Personal Development