Smithers Lions Club Application For An Education Bursary

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1 Smithers Lions Club Application For An Education Bursary General Information: Bursaries are available to students enrolled in post-secondary programs and attending accredited public colleges and universities. The prime criteria is demonstrated financial need. As education awards are supplemental assistance, it is expected that you have applied to all sources normally available to students and that the main funding is in place. This bursary is "not" applicable to those students applying for admission to year 1 (one) of their post-secondary education nor for those post-graduate students working towards a Masters degree. Eligibility: 1. Must be a Canadian citizen or landed immigrant. 2. Must have graduated from a Smithers secondary school. 3. Must plan to register as a full-time student in the 2016/2017 school year at a recognized postsecondary institution. 4. Must have acceptable grades. 5. Must have volunteer experience and must include an essay on, Why do you believe volunteering is important to your community? Submission Deadline: The application must be received at the Smithers Lions Club address by September 30, Bursaries will be disbursed before the end of October. Mail Completed Application To: Smithers Lions Club Box 925 Smithers, B.C. V0J 2N0 Attn: Bursary Committee Award Process: Applications received by the deadline will be reviewed by committee who will take into consideration the actual need, the length of the program, the year of study, efforts to minimize costs, personal statement of special circumstances, grades, volunteer experience, etc. Your submission must include copies of: - your most recent transcript - a school printout of courses in progress - and a notice of your student loan (if applicable) Incomplete applications will not be reviewed!

2 Personal Information (please print): Last name: First name & middle initial: Mailing address: Permanent address (if different than mailing address) Phone number: address: Date of birth: Citizenship Status (check one): Canadian Citizen Landed Immigrant Marital Status: Single Single Parent Married (includes common-law) Accommodation during studies (check all that apply): Live with parents Basement suite Payments are shared Room & board Apartment (# of persons? ) No rent is paid Campus residence Own property Live by myself House/Townhouse Co-operative housing Proposed Program Of Study: Name of Institution: Location (city): Program enrolled in: Program length (years) is: Which year of study will you be entering? (2 nd, 3 rd, 4 th ): Number of credits that are being taken each semester/year: Certificate/Diploma/Degree Expected: Education History: What Smithers High School did you graduate from and when: What other post-secondary institution(s) have you attended: When & Number of Years attended: Certificate/Diploma/Degree Completed: Employment History (most recent first): Company/employer s name: (continued on next page)

3 Company/employer s name: Company/employer s name: Will you be employed while attending school? Yes - No - Full-time - Part-time If yes, where? Volunteer Experience: (Attach a separate list if additional space is required.) Current volunteer work: Past volunteer work: Extenuating or financial issues: (issues you feel we should be aware of in considering your application, ex health, accident, family, etc...) Explain Extraordinary Expenses: Financial Information: Net income for Estimated net income for

4 Financial Estimates (Budget) Covering the Period of Attendance for the Current (2016/2017) School Year Only: From, to, which equals months.* month year month year *The number of months is the number your monthly resources or expenses should be multiplied by to provide a total. Resources: Expenses: Savings at the beginning of the school year Tuition: (Do not include costs other than tuition) Applicant s net earnings while attending school Awards: Scholarships Bursaries Grants, Research Funds, etc. Awards Total Contributions: Spouse s net income Parental or other Support Payments/Alimony per credit x credits or 1 st term + 2 nd term or per week x no. of weeks Activity/association fees _ Books & Supplies _ Equipment & Uniforms _ Transportation (Local): Tuition Total _ Other School Costs Total _ Total Contributions Sponsor/Government Income: TAC, WCB Vocational Rehabilitation Employment Insurance Band Funding Ministry of Human Resources Child Tax Credit/Family Bonus Orphan Benefits GST Rebates Sponsor/Government Income Total Other Income: Asset rental, interest RESPs, RRSPs Other Other Income Total SUB TOTAL Repayable Loans granted for this school year: Canada Student BC Student Bank or private loans Total Repayable Loans TOTAL RESOURCES Public bus Fuel Car Maintenance Car Insurance Parking Transportation (Distant): Return Trip Home Shelter Costs: Transportation Costs Total Rent or mortgage Heat & Light Insurance/Property Taxes Shelter Costs Total _ Food Food Total _ Medical & Dental Medical & Dental Total _ Miscellaneous: Personal care/entertainment Phone, cable, internet Daycare Less subsidy = Car loan/lease payments Other loan payments (specify ) Credit card payments Miscellaneous Total _ TOTAL EXPENSES _ TOTAL EXPENSES _ MINUS TOTAL RESOURCES _ = SHORTFALL

5 Future Plans: (Briefly outline your plans for your future career or profession and how this bursary would assist you in achieving your goals) Please attach to this application an essay of at least 500 words answering the question, Why do you believe volunteering is important to your community? Privacy Statement and Application Agreement: Personal information under the control of the Smithers Lions Club shall remain confidential and shall not, without the consent of the individual to whom it relates, be used by the Smithers Lions Club except: a) for the purpose for which the information was obtained or compiled by the Smithers Lions Club or b) for a use consistent with that purpose. By completing and authorizing this application, you consent to the use of your personal information for: a) processing of the application b) publication of your name in the media and/or c) promotional purposes. I hereby certify that all information is accurate and can be verified upon request. I hereby acknowledge and agree to the above privacy statements and use of my personal information by the Association. Signature of Applicant (or of parent/guardian if applicant is not of the age of majority) Date of Application Check List: Application completed fully Essay Your most recent school transcript School printout of courses in progress Notice of student loan

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