Get Greenshield Scholarship Form

This guide provides clear and supportive instructions on completing the Greenshield Scholarship Form online. Following these steps will ensure you accurately fill out the necessary information for scholarship consideration.

Follow the steps to successfully complete the form.

1. Press the ‘Get Form’ button to access the Greenshield Scholarship Form and open it for editing.
2. Begin with Section 1, which requires employee information. Enter your Green Shield ID number, company name, date of birth, first name, surname, address, telephone number, province, city, and postal code.
3. Move to Section 2 and fill in the student information. Provide the student’s name, address, Green Shield ID number, province, city, date of birth, postal code, and dependent’s Social Insurance Number.
4. In Section 3, complete the mandatory declaration. Indicate whether you have other group insurance coverage. If yes, include the name of the insurance company and attach a copy of the statement from the primary carrier. State the name and address of the educational institution, and check applicable boxes for degree or diploma programs and student status.
5. For Section 4, provide detailed information about the course program. Fill in the name of the degree or diploma program, program number, start and end dates of the term, total course load, and tuition costs, ensuring that it does not include additional fees.
6. In Section 5, sign to certify the tuition expense obligation and acknowledge that the information is complete and accurate. Include the date of signature.
7. Finally, in Section 6, review the mailing instructions. Ensure all original correspondence is attached, keep copies for your records, and submit the claim within 12 months of service. Address the envelope to Green Shield Canada, as indicated.

Take action now and complete the Greenshield Scholarship Form online to secure your scholarship opportunity.