NOTICE, CONSENT, DECLARATION, AND SIGNATURE OF THE APPLICANT

Your personal information provided on this application form, the required supporting documentation, and all other communications related to your application will be used by Fourth Wave to administer the program. The personal information on
this form is collected under the Freedom of Information and Protection of
Privacy Act (FIPPA), R.S.O. 1990, c. F.31 as amended. The information provided will not be used for any purposes other than those stated on this form unless the applicant offers expressed consent.

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APPLICANT’S CONSENT TO THE INDIRECT COLLECTION AND DISCLOSURE OF PERSONAL INFORMATION

I agree that IOUC Fourth Wave can, without limitation, collect, use, and disclose personal
information about me that is relevant to the consideration of my scholarship application with its Board members and the selection committee members it appoints to assess my application.

APPLICANT’S DECLARATION

I hereby certify that the information provided on this application is, to the best of my
knowledge, accurate and complete, and I authorize the release of the information contained
herein to the Selection Committee.