Dr. Norah Browne Graduate Studies Scholarship

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The mandate of Canadian Hard of Hearing Association- Newfoundland and Labrador (CHHA-NL) is to encourage awareness of hearing loss issues among the general public, to create greater hearing accessibility to public facilities and to advocate for the rights of hard of hearing or late-deafened or oral deaf people. Dr. Norah Browne Graduate Studies Scholarship CHHA-NL is pleased to offer its Scholarship Program for hard of hearing, late-deafened and oral deaf post secondary graduate students. First preference will be given to applicants who graduated from a High School in Newfoundland and Labrador. If no such applications are received, applicants who have lived in Newfoundland & Labrador for a minimum of 12 consecutive months will be considered. All eligible scholarship applications, with the exception of the Audiology Scholarship, will be automatically considered for the Horn-Smith Merit Scholarship ($1000). Candidates will not be required to submit an additional application to apply for this scholarship. The scholarship has been established to honor Dr. Norah Browne, who was the founding President of the Association. She was instrumental in growing the Association, creating greater public awareness of the hearing accessibility needs in public facilities, and for being a strong and forthright advocate for the rights of all hard of hearing persons. The scholarship, awarded annually, is a testament to her work and passion. The purpose of the Dr. Norah Browne Graduate Studies Scholarship is to offer financial assistance and recognition to hard of hearing, late-deafened and oral deaf students registered in a full time graduate program at a recognized Canadian college or university, in any area of study. A thousand dollars ($1000) for two semesters, a total of $2000, will be awarded to one student during the academic year of study. Please note: In the event there are no applicants for the Dr. Norah Browne scholarship that meet the above noted residency and hearing loss criteria, a candidate with a documented auditory processing disorder may be considered for the scholarship. Applicants are requested to read the criteria for eligibility found in the section entitled Policies and Procedures (attached) and to provide all the information required. Please ensure that all necessary documentation is completed, signed and that all supporting material is enclosed (copies are acceptable as applications will not be returned). While applicants may apply for both the Dr. Norah Browne Graduate Studies Scholarship and the CHHA-NL Audiology scholarship, they may not receive both scholarships in the same calendar year. Applications must be received by June 30. Late, unsigned or incomplete applications will not be considered. Please note the following: 1. Scholarship applicants cannot be employees, Board members of CHHA-NL, or immediate family members of the aforementioned. 2. The scholarship is awarded upon proof of registration from the institution s registrar.

Dr. Norah Browne Graduate Studies Scholarship POLICY AND PROCEDURES 1. Applicants of this scholarship must be either Hard of Hearing or Late- Deafened or Oral Deaf. In the event there are no applicants for a scholarship that meet the above noted applicant criteria, a candidate with a documented auditory processing disorder may be considered for a scholarship award. Preference will be given to candidates who are hard of hearing, late-deafened or oral deaf. The Canadian Hard of Hearing Association- Newfoundland and Labrador (CHHA-NL) accepts the following definitions of hearing loss: Hard of Hearing: A person with any level of hearing loss, from mild to profound, whose primary method of communication is the spoken language. Late- Deafened: A person with a profound level of hearing loss acquired in adulthood (hearing loss occurred after learning oral communication). Oral Deaf: A person with a profound level of hearing loss, occurring congenitally or with an onset early in life, whose primary method of communication is the spoken language. 2. Eligible applicants must be registered as a graduate student at any post-secondary institution in Canada. The field of study is not a factor in the selection process. First preference will be given to applicants who graduated from a High School in Newfoundland and Labrador. If no such applications are received, applicants who have lived in Newfoundland & Labrador for a minimum of 12 consecutive months will be considered. 3. Eligibility for the Dr. Norah Browne Graduate Studies Scholarship is based on an overall assessment of the applicant. Applications will be judged by a number of criteria including academic achievement, determination to cope with hearing loss, and community involvement (See Application Form for details). 4. All eligible scholarship applications, with the exception of the Audiology Scholarship, will be automatically considered for the Horn-Smith Merit Scholarship ($1000). Candidates will not be required to submit an additional application to apply for this scholarship.

5. While applicants may apply for both the Dr. Norah Browne Graduate Studies Scholarship and the CHHA-NL Audiology Scholarship, they may not receive both scholarships in the same calendar year. 6. Funds will be distributed upon receipt of proof of registration. An agreement to this effect will be signed by the recipient and appropriate CHHA-NL authority. In certain circumstances, a deferment of the award may be granted with a written request. Please note that scholarships are taxable income. 7. Recipients must agree that names and/or photographs may be used for promotion of the CHHA- NL Scholarship Program and to encourage future applicants. Mediums may include but not limited to the following: CHHA-NL s website www.chha-nl.ca, CHHA-NL s e-newsletter Sound Ripples, CHHA-NL newsletter Sound Waves, CHHA National s Listen Magazine, CHHA Conference and Annual General Meeting, local newspapers (in recipient s community) and a press release to national media.

I am applying for: Canadian Hard of Hearing Association- Newfoundland and Labrador Scholarship Application Form Audiology Scholarship Applicants: Please see Audiology Scholarship Application CHHA-NL Entrance Scholarship (for first-year students only) Glenna Stone Memorial Scholarship (for undergraduate students beyond 1 st year of studies) Dr. Norah Browne Graduate Studies Scholarship X Horn-Smith Merit Scholarship (All eligible scholarship applications, with the exception of the Audiology Scholarship, will be automatically considered for the Horn-Smith Merit Scholarship ($1000). Candidates will not be required to submit an additional application to apply for this scholarship. Application Deadline: June 30 Please Note: Incomplete applications will not be considered. It is your responsibility to ensure your application is complete and all information is received before June 30. You may contact CHHA-NL at any time to determine if your application and all supporting documents have been received. Application criteria, forms, and reference guidelines are available at www.chha-nl.ca or by contacting our office. Section 1: Please fill in necessary information, and write an X in the boxes where necessary: First Name: Address: Province: Phone/TTY: I consider myself to be: Last Name: City: Postal Code: Email: Hard of Hearing Oral Deaf Late Deafened Other (specify) For Office Use Only: Meets Residency Yes No Received Personal Yes No Requirements Statement: Received Audiogram: Yes No Received Transcript: Yes No Number of References Received 1 2

I have been a resident of Newfoundland & Labrador for the past 12 consecutive months: Yes No I graduated from a Newfoundland & Labrador High School: Yes No I am a: High school graduate entering my first year of post-secondary education. Full-time college or university student and have already have begun my post-secondary education. Mature student starting post-secondary for the first time. Mature student returning to post-secondary. Other (specify in space provided): Please outline your education history, including current program of study: Name of High School/Post Secondary: Program (If Applicable): Diploma/Degree Received: Section 2: The following information MUST be provided to ensure eligibility for this scholarship. You MUST also include a recent (within the past 3 years) AUDIOGRAM signed and dated by an audiologist. Please fill in necessary information, and write an X in the boxes where necessary (Worth 30 points of your application): Age when hearing loss was diagnosed:

Cause (if known): Do you require hearing aids: Yes Sometimes No Do you wear hearing aids: Yes Sometimes No If you answered yes to wearing hearing aids, how many do you wear?: Do you have a cochlear implant? Yes No Do you wear a cochlear implant? Yes No If you answered yes to having a cochlear implant, how many do you wear?: If you answered yes to having a cochlear implant, what age did you receive it?: Do you have any other disabilities in addition to hearing loss? Yes No If you answered yes to having any other disabilities, please explain: Please answer the following questions reflecting upon your CLASSROOM ACCESSIBILITY needs (ie: how you address your hearing loss in the classroom): Do you require hearing aids? Yes No Do you use hearing aids? Yes Sometimes No Do you have a cochlear implant? Yes No Do you use your cochlear implant? Yes Sometimes No Do you require FM? Yes No Do you use FM? Yes Sometimes No Do you require preferred seating? Yes No

Do you use preferred seating? Yes Sometimes No Do you require note takers? Yes No Do you use these notes/this service? Yes Sometimes No Other Accessibility Needs? Yes No If you said yes for other, please explain: Section 3: Personal Statement. Please answer the following four questions to the best of your ability. Answers should be typed and enclosed with your application (Limit: 1000 Words) (Worth 50 points): 1) Please outline your educational goals (ie. To obtain college diploma, university degree, etc.) AND outline your career aspirations. 2) Please give an example of a time, if any, when you promoted awareness of hearing loss issues. 3) Please give an example of an occurrence, if any, when you identified yourself as a person with hearing loss. 4) Please provide a personal statement describing how you believe hearing loss has affected your life, and how you believe you have overcome the challenges associated with hearing loss. Additionally, please outline any past achievements, personal highlights and/or participation in sports, clubs, or organizations. Describe your plans for the future and any other goals you hope to achieve. Section 4: Please include two letters of reference, typed, not to exceed 500 words. Individuals providing references should be directed to use the Reference Guideline Form. References must be from someone other than your immediate family or anyone living in your household. Some examples of possible references include itinerant teacher, teacher, employers or places where you have volunteered(worth 20 Points). Thank you for your application for the Canadian Hard of Hearing Association- Newfoundland and Labrador (CHHA-NL) Scholarship Program. Your submission will be carefully reviewed by the Scholarship Committee. Only successful applicants will be notified. Scholarships are granted on a one-time basis, though you may apply in successive years if this application is not selected. Please note that the decisions of the Scholarship Committee are final. Applicant Signature Date

Please Submit Applications by mail or fax to: Canadian Hard of Hearing Association- Newfoundland and Labrador (CHHA-NL) 1081 Topsail Road, Mount Pearl, NL, A1N 5G1 For further information: Fax: (709) 753-5640 Web: www.chha-nl.ca E-mail: info@chha-nl.ca Phone: 1-888-753-3224 Text: (709) 725-3224 CHECKLIST: Please ensure that your application package includes the following documents: This completed application Form A signed audiogram A copy of your most recent school transcript Your answers to Section 3 Two reference letters in accordance with reference guidelines Note: Please remind your references that, if submitted by mail, all letters must be received by June 30 th.

Reference Guideline Form Thank you for providing the Canadian Hard of Hearing Association- Newfoundland and Labrador (CHHA-NL) Scholarship Committee with a reference letter for a potential scholarship winner. CHHA-NL will evaluate the student on the information you provide based on the following questions: 1) Do you feel this person is deserving of a CHHA-NL scholarship? Why? 2) Does this person require and consistently use hearing assistive technology where appropriate (i.e. hearing aids, FM, a sound field system, etc.)? 3) Does this individual self-identify as a person with hearing loss? 4) Does this person positively promote awareness of hearing loss (i.e. at school, in their community)? All reference letters must be received by June 30 th in order for the student to qualify for the scholarship. Reference letters may be provided to the applicant in a sealed envelope or, may be sent by mail, or delivered in person, to CHHA-NL. Canadian Hard of Hearing Association- Newfoundland and Labrador (CHHA-NL) 1081 Topsail Road, Mount Pearl, NL, A1N 5G1 Toll Free: 1-888-(753-3224) Text: (709) 725-3224 Fax: (709) 753-5640 Web: www.chha-nl.ca E-mail: info@chha-nl.ca