FALL 2014 ECE BURSARY APPLICATION FORM Instructions: Please review our ECE Bursary information and criteria at www.ecebc.ca prior to filling out this form. Answer all questions in ink. Incomplete and/or illegible applications will not be accepted. Applications that are missing supporting documentation will not be considered Deadline for submission of bursary application forms is November 7, 2014. Application forms received after the deadline will not be considered. This bursary application form is three pages in length, please fill in all sections. Include a copy of your approved/received registration form with this application.
Personal Information Last Name:
First Name:
Address: Province:
City: Postal Code:
Phone:
E-mail:
The following three questions are for the purpose of collecting statistical information regarding the students supported by the ECE Bursary fund. No personal information will be shared, and applicants’ privacy will be protected: Do you identify yourself as an Aboriginal person; that is, First Nations, Métis or Inuit?
Yes
No
If you identify yourself as an Aboriginal person, are you First Nations, Métis or Inuit? _____________________________
Name of Institution:
Student ID
Campus: Social Insurance Number
Program of Study:
-
Full time / Part time:
From September to December 2014 how many courses are you enrolled in? Both international and domestic students are eligible to apply for the ECE student bursary, however, proof of BC residency must be submitted with your application. Without proof of BC residency, ECEBC is unable to consider your application. ECE Bursary Application Form – Fall 2014 Semester
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FALL 2014 ECE BURSARY APPLICATION FORM Career and Educational Goals: (If insufficient space, please attach additional letter)
Living Arrangements Single student - living with parents
Single student – living away from home
Married/Common Law - no children Single parent
(# of children _________ - ages of children _________)
Married/Common Law - with children
(# of children _________ - ages of children _________)
Spouse’s Net Annual Income:
(if applicable)
Financial Information To get a monthly figure: If you are attending school full time If your school runs on a semester basis, take the tuition amount that was paid for the semester and divide it by 4 (there are four months in a semester ) Otherwise take the tuition amount that you paid for the year and divide it by the number of months in your program if you are attending school part time Add up the tuition amount that you paid for each course you are taking and divide it by 4 (there are four months in a semester) PLEASE NOTE: Your application may be audited. Please keep all supporting documentation such as receipts, bank statements, cancelled cheques, etc. Giving false or misleading information could result in your application being denied.
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FALL 2014 ECE BURSARY APPLICATION FORM MONTHLY INCOME
Amount $
MONTHLY EXPENSES
Employment/self employment
Rent/mortgage
Student loan (average)
Groceries
First Nations or MĂŠtis sponsorship
Medications (uninsured)
Employment insurance
Electricity, heat, and water
Social Assistance
Internet access
Pension(s)
Telephone/cell phone
BC family bonus
Child care
Child tax credits
Child school expenses (average)
Child care subsidy
Child bus passes
Child support
Child support payments
Spousal support
Clothing (yourself and family)
Tax rebates (average)
Gifts (average)
Commissions
Car/home insurance (average)
Bursaries/scholarships
Car payment
Other
Gas and parking
Amount $
Loan/credit card payment Miscellaneous (specify) Tuition and ancillary fees Textbooks TOTAL MONTHLY INCOME
TOTAL MONTHLY EXPENSES
On a separate sheet of paper, please provide any other information that you feel may help in determining your financial need.
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FALL 2014 ECE BURSARY APPLICATION FORM Authorization and Declaration I hereby declare that the information contained herein, all statements made and all supporting documents submitted in connection with this application are true, correct and complete. I understand that any misrepresentation or incomplete disclosure on or relating to this application may result in the cancellation of an award, or repayment of an award. I agree to provide ECEBC with proof of successful completion of the courses for which I am applying. I also understand I will not receive any funds until these documents are supplied. Transcript must be received by ECEBC by January 30, 2015. (Please see Bursary Information Sheet on our website www.ecebc.ca) Successful completion requires a minimum of a passing grade. Applications received by email will constitute agreement of the above authorization and declaration.
Signature of Applicant :
Date:
_________
You may submit your application form by: e-mail: membership@ecebc.ca Fax: (604) 709-6077 Mail: ECEBC ECE Student Bursary Program 2774 East Broadway, Vancouver BC V5M 1Y8
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FALL 2014 ECE BURSARY APPLICATION FORM
Before you submit your bursary application, don’t forget to: Include proof of registration for the semester (this must include your name, number of courses you are registered in, semester and year).
Complete all sections of the bursary application. This includes stating all expenses and all sources of income/financial assistance on page 3.
Submit proof of BC residency. I have read and understand ECEBC’s ECE student bursary policy. Submit your transcript by the deadline.
Incomplete and/or illegible applications will not be accepted. Page 5 of 5