Use the electronic application form below to submit your entry for the Dick Martin Scholarship.
If you would prefer to mail or fax in your entry please download and fill in the Dick Martin Scholarship Award Application ![]()
Provision of the information requested on this form is voluntary. We will use your personal information for the following purpose(s):
- The information is being collected to provide information for the purpose of awarding scholarships which you have elected to submit an application for.
- The information collected on this form/Web page is described in Personal Information Databank Automated Document, Records, and Information Management Systems Bank Number: PSU 904.
- Retention and Disposal Standards: For information about the length of time that specific types of common administrative records are maintained by a federal government institution, including the final disposition of those records, please contact the institution's Access to Information and Privacy Coordinator.
Your personal information is protected under the federal Privacy Act, which states that you have the right to access your personal information and request changes to incorrect information. If you wish to avail yourself of this right or require clarification about this Statement, contact our Privacy Coordinator by email at privacy@ccohs.ca or by calling 905-572-2981 ext 4401 or writing to 135 Hunter St E, Hamilton, ON L8N 1M5. For more information on privacy issues and the Privacy Act in general, consult the Office of the Privacy Commissioner Web site or call 1-800-282-1376.
The transmission of this optional information is not secure and so sensitive personal information, for example, your Social Insurance Number, should not be included in your message.
If after reading this statement, you prefer to submit your comments off the Internet, use one of the following methods:
- By Telephone: 905-572-2981
- By Mail: 135 Hunter St E, Hamilton, ON L8N 1M5
- In Person at: 135 Hunter St E, Hamilton, ON L8N 1M5
To learn more about Dick Martin, the scholarship opportunity, or to submit an application use the links in the sidebar or contact CCOHS at 1-800-668-4284.




