The Royal Conservatory School BURSARY ASSISTANCE PROGRAM APPLICATION FORM FOR THE ACADEMIC YEAR

Size: px
Start display at page:

Download "The Royal Conservatory School BURSARY ASSISTANCE PROGRAM APPLICATION FORM FOR THE ACADEMIC YEAR"

Transcription

1 The Royal Conservatory School BURSARY ASSISTANCE PROGRAM APPLICATION FORM FOR THE ACADEMIC YEAR Mail, fax, or hand your completed application to The Royal Conservatory School Registration Desk by 5:00 P.M. on Monday, March 31st, 2014 The Royal Conservatory School 273 Bloor Street West, Toronto, ON M5S 1W2 Phone: Fax:

2 THE ROYAL CONSERVATORY SCHOOL BURSARY APPLICATION 2014/2015 ELIGIBILITY In general bursaries are awarded through the RCS Subsidized Spaces Program. Assistance is based on gross household income, and awarded according to the following schedule: Gross Household Income Maximum Eligible Tuition Subsidy $50,000 and up 0% $40,000-$49,999 25% $30,000-$39,999 50% $20,000-$29,999 75% Under $20, % In determining awards, the Bursary Committee considers primarily family financial need, as well as such factors as temporary unemployment, emergencies, illnesses, and the total cost of music education. POLICIES I) Receipt of an application does not oblige the RCS to grant a bursary. II) Awards are final and are not subject to appeal. III) Bursary funds can only be used for the program for which the applicant requested financial assistance. IV) Bursary awards off-set RCS tuition only; funds may not be used towards supplemental fees, books, instruments, examinations or other costs associated with musical education at the RCS. V) Applicants are urged to register using the monthly payment plan, as bursary funds can only be deducted from tuition owing. VI) Bursaries are awarded for use in the 2014/2015 Academic Year which begins September 8, VII) Bursaries that are applied to full-year tuition are applied in two installments (one half of the award amount applied to each term of study). VIII) Students must acknowledge the bursary donor where applicable. Funds will be withheld from the IX) student until a letter of thanks has been received by Registration & Student Services. The RCS reserves the right to withdraw a bursary at any time if the behaviour exhibited by the student while at The RCM is deemed inappropriate by the Director of the RCS. X) If the student enrolls in the Glenn Gould School or the Phil and Eli Taylor Performance Academy for Young Artists the 2014/2015 Academic Year, any bursary assistance received through the RCS for the same year shall be automatically forfeited, unless the GGS or the Academy instrument discipline is other than that for which the RCS award has been granted. APPLICATION DEADLINE Applications are due by 5:00 p.m. on Friday March 31st, See front cover for contact information. APPLICATION PACKAGE Incomplete applications will not be considered. Please complete the checklist on the final page. We do not contact applicants for missing information. RESULTS All complete applications will be reviewed by the Bursary Committee within two weeks of the formal application deadlines. Only applicants receiving awards will be contacted. All unsuccessful applications will be held for the duration of the academic year and will be considered should any additional funding become available.

3 BURSARY APPLICATION FORM 2014/2015 ACADEMIC YEAR RCM #: Date of Birth: (YYYY/MM/DD) Age: Name: Address: First Name Last Name Apt # Address Daytime telephone # Evening telephone # address Parent or Guardian if applicant is under 16 Telephone # Discipline & term(s) for which you are applying for bursary: Present music teacher: Name Telephone # address Have you previously applied for an RCS bursary? Are you currently a student at The Royal Conservatory School? Yes No Yes No If yes, which classes/lessons are you taking? Please list past awards for musical study: Year Amount Instrument/Program Source of Assistance (Award Name) Briefly state your musical goals and how a bursary would help achieve them:

4 Musical Education Information (Practical & Theoretical) Name of School (if applicable) Subject/Level RCM Exam Mark Teacher General Education Information Name of School(s) Years Attended Grade/Program Completed General Personal Information Bursary donors often like to know something about the recipients of their awards; please tell us about yourself. I have read and understood the terms of bursary application, and agree to comply with all policies of The Royal Conservatory School. Candidate s Signature Parent s/guardian s Signature (if under 16) Date

5 THE ROYAL CONSERVATORY SCHOOL BURSARY APPLICATION 2014/2015 FINANCIAL INFORMATION FORM SECTION 1: PERSONAL INFORMATION: to be completed by the person or people who pay tuition that is, by the adult student applying for funding, or by all parent(s)/guardian(s) applying for funding on behalf of financially dependent student. Note: Families with multiple incomes must report the entire household income. Adult applicants (19 and over) must submit: personal information about yourself and your spouse. Financially dependent students (18 and younger) must submit: personal information about the parent(s) and or guardian(s). 1.1 Parent/Guardian #1 or Adult Applicant First Name Last Name Apt # Address Daytime telephone # Evening telephone # address 1.2 Marital Status: Single Married/Common-law Relationship Divorced Separated Widowed 1.3 Number of children 16 years and younger that you and your spouse (if applicable) support 1.4 Do you receive subsidized child care? Yes No 1.5 Parent/Guardian #2 or Spouse of Adult Applicant First Name Last Name Apt # Address Daytime telephone # Evening telephone # address 1.6 A letter stating why bursary assistance is required and outlining the efforts that are being made to meet financial needs must be attached and signed by the applicant and parent(s) or guardian(s). A letter explaining the applicant s need for bursary assistance is attached. YES NO

6 SECTION 2: EMPLOYMENT INFORMATION 2.1 Parent/Guardian #1 or Adult Applicant current employment status: Full-Time Self-employed Part-Time Unemployed If unemployed, list source(s) of government income/support. (e.g. Ontario Works, Ontario Disability Support Programs, Employment Insurance, etc.) 2.2 Parent/Guardian #2 or Spouse of Adult Applicant current employment status: Full-Time Self-employed Part-Time Unemployed If unemployed, list source(s) of government income/support. (e.g. Ontario Works, Ontario Disability Support Programs, Employment Insurance, etc.) 2.3 Provide your employment history by listing your jobs and the periods in which you received government assistance: (e.g., Ontario Disability Support Programs, Family Benefits, Ontario Works, or Employment Insurance). Start with your most recent position (attach a separate sheet if you need more space). Name of employer or source of government income City, province, and country in which you worked From To Month Year Month Year SECTION 3: INCOME INFORMATION 3.1 Estimated gross income for the current year Parent/Guardian #1 or Adult Applicant $ Parent/Guardian #2 or Spouse of Adult Applicant $ Include income from all sources, except GST rebates, Child Tax Benefits, assistance received through the federal Universal Child Care Benefit. Do not include pain and suffering awards, including WSIB Non-economic loss (NEL) awards, in amounts less than $100,000. Any amount over $100,000 is considered income in the period it was received. If payments are made for different incidents, the payments related to each incident are exempt up to $100, Type of government income expected to receive in the current year (if applicable) Unemployment Insurance Employment and Training Allowance Ontario Disability Support Program Loss of Earnings Benefits (WSIB) Ontario Works Other 3.3 Proof of Income Proof of income for Parent/Guardian #1 or Adult Applicant attached Proof of income for Parent/Guardian #2 or Spouse of Adult Applicant attached Proof of income must be provided for both Parent/Guardian #1 or Adult Applicant and Parent/Guardian #2 or Spouse of Adult Applicant (if applicable). Proof of income includes copies of pay stubs from Ontario Disability Support Program (ODSP) or Ontario Works (OW) (or a letter from a caseworker), pay stubs from other government income such as Canada Pension Plan Disability Benefits, Loss of Earning Benefits (WSIB) or Employment and Training Allowance, copies of employment pay stubs, and letters from employers confirming actual gross monthly income. CHECKLIST Completed application form Completed financial information form Sections 1, 2 & 3 Letter explaining applicant s need for bursary assistance (section 1.6) Proof of income (section 3.3)

Street No: Street Name: Apt No: City: Province: Postal Code: Fax Number: ( )

Street No: Street Name: Apt No: City: Province: Postal Code: Fax Number: ( ) The Applicant The person with the disability is referred to as the Applicant. All questions should be answered by the Applicant or on his / her behalf. Please provide information for one Applicant per

More information

Medical Financial Assistance

Medical Financial Assistance Medical Financial Assistance YOU MAY BE ELIGIBLE FOR MEDICAL As a nonprofit health plan, Kaiser Permanente strives to help people in need of financial assistance for unforeseen medical expenses. Households

More information

Healthy Smiles Ontario Program Application Form A

Healthy Smiles Ontario Program Application Form A Ministry of Health and Long-Term Care Healthy Smiles Ontario Program Application Form A Program Information The Healthy Smiles Ontario Program is an Ontario government-funded basic dental program providing

More information

Application for Subsidized Housing

Application for Subsidized Housing Peel Region Upon completion, please return to: Peel Access to Housing Region of Peel - Human Services Large print applications are available upon request Disponible en français Application for Subsidized

More information

SIGNATURE OF APPLICANT: DATE. Please read the notes and instructions in the financial aid brochure before completing the application form.

SIGNATURE OF APPLICANT: DATE. Please read the notes and instructions in the financial aid brochure before completing the application form. PLEASE NOTE: WALTER SISULU UNIVERSITY FINANCIAL AID APPLICATION FORM 2015 ACADEMIC YEAR CLOSING DATE (currently registered students): 30 SEPTEMBER 2014 CLOSING DATE (first time entrants to WSU): 30 NOVEMBER

More information

One Affordable Homeownership Unit - Adaptable Unit with Accessible Features

One Affordable Homeownership Unit - Adaptable Unit with Accessible Features One Affordable Homeownership Unit - Adaptable Unit with Accessible Features Located at 100 Pacific Street near Central Square, this unit will be available, through the City s Inclusionary Housing Program,

More information

Financial Assistance

Financial Assistance Financial Assistance Process & Application The Ochsner Health System ( OHS ) is committed to providing financial assistance for patients with a demonstrated financial need or hardship, who have received

More information

Simon Scholar Application Class of 2018

Simon Scholar Application Class of 2018 Simon Scholar Application Class of 2018 Please attach your photo here STUDENT INFORMATION (Note: Please complete application in black ink only DO NOT USE A PENCIL) Name: First MI Last Last 4 digits of

More information

Mississippi Office Of Homeland Security P. O. Box 958 Jackson, MS 39205

Mississippi Office Of Homeland Security P. O. Box 958 Jackson, MS 39205 Mississippi Office Of Homeland Security P. O. Box 958 Jackson, MS 39205 First Responder Scholarship Application Criteria: The goal of the Mississippi Office of Homeland Security scholarship program is

More information

Application for Interest Relief P.O. Box 1008 Station "B" Mississauga, Ontario L4Y 3W3

Application for Interest Relief P.O. Box 1008 Station B Mississauga, Ontario L4Y 3W3 Application for Interest Relief P.O. Box 1008 Station "B" Mississauga, Ontario L4Y 3W3 SECTION 1 APPLICANT INFORMATION Last Name First Name Birth Date MM / DD / YYYY S.I.N. Mailing Address : Primary Telephone

More information

2015-2016 REQUEST FOR CONSIDERATION OF SPECIAL CIRCUMSTANCES

2015-2016 REQUEST FOR CONSIDERATION OF SPECIAL CIRCUMSTANCES Financial Aid Office PO Box 359 Sheboygan, WI 53082-0359 Fax: 920-565-1070 INDEPENDENT STUDENT 2015-2016 REQUEST FOR CONSIDERATION OF SPECIAL CIRCUMSTANCES Student Name: Social Security or LC Student ID

More information

COUNTY & DISTRICT CLERKS ASSOCIATION OF TEXAS

COUNTY & DISTRICT CLERKS ASSOCIATION OF TEXAS COUNTY & DISTRICT CLERKS ASSOCIATION OF TEXAS SCHOLARSHIP PACKET This scholarship packet includes information, guidelines and an application. BYLAWS OF THE COUNTY & DISTRICT CLERKS ASSOCATION OF TEXAS

More information

2. It is a requirement that you submit proof of ALL income for yourself and spouse/significant other for the past 3 months.

2. It is a requirement that you submit proof of ALL income for yourself and spouse/significant other for the past 3 months. Dear Child Care Client: Enclosed is a Child Care Assistance Application information packet. Please read the entire packet carefully so that you will understand and comply with all requirements, thus ensuring

More information

APPLICATION FOR A BURSARY FOR TERTIARY EDUCATION

APPLICATION FOR A BURSARY FOR TERTIARY EDUCATION APPLICATION FOR A BURSARY FOR TERTIARY EDUCATION GENERAL INFORMATION 1. The Epilepsy South Africa Educational Trust exclusively awards bursaries to persons with epilepsy. 2. The Trust will only fund tuition

More information

GUIDE TO THE APPLICATION FOR FINANCIAL ASSISTANCE

GUIDE TO THE APPLICATION FOR FINANCIAL ASSISTANCE GUIDE TO THE APPLICATION FOR FINANCIAL ASSISTANCE Information pages to be retained by the student PLEASE READ THE INFORMATION AND INSTRUCTIONS CONTAINED IN THE FOLLOWING PAGES CAREFULLY BEFORE COMPLETING

More information

Summer Academic Program for Elementary School Students (SAPESS) Financial Aid Scholarship 2016

Summer Academic Program for Elementary School Students (SAPESS) Financial Aid Scholarship 2016 Summer Academic Program for Elementary School Students (SAPESS) Financial Aid Scholarship 2016 Financial Aid Application 2016 1. We do receive a large number of financial aid scholarship applications.

More information

2014 APPLICATION FORM

2014 APPLICATION FORM Please attach a recent photo of you. INSTRUCTIONS: 2014 APPLICATION FORM Each candidate must complete one (1) copy of this form, which is to be either typewritten or hand written legibly in BLUE OR BLACK

More information

CHILD CARE FINANCIAL ASSISTANCE Summer Camp Program - Application for 2015 IMPORTANT PLEASE READ

CHILD CARE FINANCIAL ASSISTANCE Summer Camp Program - Application for 2015 IMPORTANT PLEASE READ Checklist IMPORTANT PLEASE READ To qualify for Child Care Financial Assistance you must answer to the following questions: Are you and your child a resident of New Trier Township? Is this program state

More information

HOME IN PEEL AFFORDABLE OWNERSHIP PROGRAM 2014 Application Form

HOME IN PEEL AFFORDABLE OWNERSHIP PROGRAM 2014 Application Form HOME IN PEEL AFFORDABLE OWNERSHIP PROGRAM 2014 Application Form The Home in Peel Affordable Ownership Program is designed to provide low to moderate income residents who are currently renting in the Region

More information

NATIONAL STUDENT FINANCIAL AID SCHEME

NATIONAL STUDENT FINANCIAL AID SCHEME NATIONAL STUDENT FINANCIAL AID SCHEME POTCHEFSTROOM FINANCIAL SUPPORT SERVICES CAMPUS IMPORTANT INFORMATION PERTAINING TO A NSFAS LOAN The main objective of the National Student Financial Aid Scheme (NSFAS)

More information

Kitsap County Veterans Assistance Program

Kitsap County Veterans Assistance Program Kitsap County Veterans Assistance Program Carefully read the information on the following pages. Bring a completed application form and your supportive documentation to any of the following locations to

More information

The Dependent Care Flexible Spending Account may be used to pay dependent care expenses that are necessary for you and your spouse to work.

The Dependent Care Flexible Spending Account may be used to pay dependent care expenses that are necessary for you and your spouse to work. DEPENDENT CARE FLEXIBLE SPENDING ACCOUNT The Dependent Care Flexible Spending Account may be used to pay dependent care expenses that are necessary for you and your spouse to work. Eligibility Employee

More information

2014-2015 Iredell County NC Pre-Kindergarten Application

2014-2015 Iredell County NC Pre-Kindergarten Application PARENTS: Please remove this top sheet and keep for your information! 2014-2015 Iredell County Parents/Families must complete this application to apply for NC Pre-Kindergarten Program (formerly the More

More information

D Arcy Lane Institute of Massage Therapy. D AL School of Equine Massage Therapy. Providing Quality Education in Massage Therapy since 1986

D Arcy Lane Institute of Massage Therapy. D AL School of Equine Massage Therapy. Providing Quality Education in Massage Therapy since 1986 September 2016 Equine Massage Therapy Program Guide Providing Quality Education in Massage Therapy since 1986 D Arcy Lane Institute of Massage Therapy D AL School of Equine Massage Therapy 627 Maitland

More information

ALBERTA CHILD SUPPORT GUIDELINES

ALBERTA CHILD SUPPORT GUIDELINES Province of Alberta FAMILY LAW ACT ALBERTA CHILD SUPPORT GUIDELINES Alberta Regulation 147/2005 With amendments up to and including Alberta Regulation 153/2009 Office Consolidation Published by Alberta

More information

Application for Financial Assistance

Application for Financial Assistance Application for Financial Assistance Funds can be used towards maintenance costs and outstanding debts such as overdrafts and credit cards. Part or all of an award may be paid directly to Accommodation

More information

TENANT CERTIFICATION PROCESS

TENANT CERTIFICATION PROCESS TENANT CERTIFICATION PROCESS Topics to be covered Tenant Certification General Information Timeframes Top 10 Tenant Cert Issues (Common Errors): Income Deductions Supporting Documentation & Verification

More information

Application for Subsidized Housing in Toronto

Application for Subsidized Housing in Toronto Application for Subsidized Housing in Toronto Large print applications are available upon request. Disponible en français 176 Elm Street If you do not speak English or French, choose someone you trust

More information

21-527EZ SUPERSEDES VA FORM 21-527EZ, AUG 2011,

21-527EZ SUPERSEDES VA FORM 21-527EZ, AUG 2011, NOTICE TO VETERAN OF EVIDENCE NECESSARY TO SUBSTANTIATE A CLAIM FOR VETERANS NON SERVICE-CONNECTED PENSION BENEFITS (This notice is applicable to veterans claims for: Non Service-Connected Pension Non

More information

Quick Tips. application 13/14. to complete the

Quick Tips. application 13/14. to complete the Quick Tips to complete the application FOR FULL-TIME POST-SECONDARY STUDIES 13/14 Contents 03» Student Aid Alberta 05» Loans and Grants 06» Application Basics 07» Money You Need: Your Expenses 08» Money

More information

Brook Haven 7781 Crystal Brook Circle * Brooksville, FL 34601 Office (352) 397-4340 Fax (813) 925-4287 RENTAL APPLICATION

Brook Haven 7781 Crystal Brook Circle * Brooksville, FL 34601 Office (352) 397-4340 Fax (813) 925-4287 RENTAL APPLICATION Brook Haven 7781 Crystal Brook Circle * Brooksville, FL 34601 Office (352) 397-4340 Fax (813) 925-4287 RENTAL APPLICATION Desired Community Name Desired Move-in Date / /20 Desired Apartment Size (check

More information

Application for Mississippi Medicaid Aged, Blind and Disabled Medicaid Programs

Application for Mississippi Medicaid Aged, Blind and Disabled Medicaid Programs Application for Mississippi Medicaid Aged, Blind and Disabled Medicaid Programs This application is used for an individual, couple or child to apply for Medicaid due to age or disability. Please read each

More information

PLEASE PRINT CLEARLY IN BLUE/BLACK INK

PLEASE PRINT CLEARLY IN BLUE/BLACK INK PLEASE PRINT CLEARLY IN BLUE/BLACK INK APPLICATION FOR NORMAL, EARLY PENSION, OR DISABILITY FORMER 144 HOSPITAL DIVISION Instructions Follow these instructions carefully and completely to avoid delays

More information

You may go to any medical provider who accepts payment from the Department of Public Aid.

You may go to any medical provider who accepts payment from the Department of Public Aid. Illinois Department of Human Services Illinois Department of Public Aid Mail-In Application for Medical Benefits (Esta solicitud está disponible en español.) (This application is available in Spanish.)

More information

Who may apply for financial aid? South African citizens.

Who may apply for financial aid? South African citizens. 1 APPLICATION FORM FOR NEW NSFAS APPLICANTS Who may apply for financial aid? South African citizens. General Instructions Please read these notes carefully before completing the application form. Make

More information

Special Circumstances Appeal Form 2015-16

Special Circumstances Appeal Form 2015-16 1 Special Circumstances Appeal Form 2015-16 Independent Students You may complete the Special Circumstances Appeal form if you are an independent student whose current financial situation is not accurately

More information

SPECIAL CIRCUMSTANCES APPEAL

SPECIAL CIRCUMSTANCES APPEAL Instructions 2012-2013 You have indicated that you and/or your family have experienced a significant change in your financial situation during 2011. We understand this may be a difficult time for you and

More information

The Actors Fund of Canada provides short-term emergency financial assistance to professionals in the Canadian entertainment industry.

The Actors Fund of Canada provides short-term emergency financial assistance to professionals in the Canadian entertainment industry. Before You Start Actors Fund of Canada Application for Assistance The Actors Fund of Canada provides short-term emergency financial assistance to professionals in the Canadian entertainment industry. You

More information

A Guide to Understanding the Trillium Drug Program

A Guide to Understanding the Trillium Drug Program Ministry of Health and Long-Term Care A Guide to Understanding the Trillium Drug Program This program may make you eligible for Ontario drug benefits TRILLIUM DRUG PROGRAM What's in this Guide 1. What

More information

MONTGOMERY WOMAN S CLUB, INC. INSTRUCTIONS FOR UNDERGRADUATE GRANT APPLICATIONS

MONTGOMERY WOMAN S CLUB, INC. INSTRUCTIONS FOR UNDERGRADUATE GRANT APPLICATIONS MONTGOMERY WOMAN S CLUB, INC. INSTRUCTIONS FOR UNDERGRADUATE GRANT APPLICATIONS 1. The Montgomery Woman s Club, Inc. (MWC) Undergraduate Grants will be awarded to undergraduate students at accredited institutions

More information

Health Charity Care Application - Requirements

Health Charity Care Application - Requirements HUTCHINSON FINANCIAL ASSISTANCE PROGRAM Thank you for your interest in Health s Financial Assistance Program. We strive to provide quality, affordable care for all of our patients and are committed to

More information

Asylum Support Application Form (ASF1)

Asylum Support Application Form (ASF1) Destitution Message Asylum Support Application Form (ASF1) Under the terms of the Immigration and Asylum Act 1999, the Secretary of State may provide, or arrange for the provision of support for asylum

More information

Maine Roads Scholarship Program Degree Information 2015-2016

Maine Roads Scholarship Program Degree Information 2015-2016 www.muskie.usm.maine.edu/maineroads Maine Roads Scholarship Program Degree Information 2015-2016 PLEASE READ BEFORE COMPLETING APPLICATION FORM I. DEFINITION The Maine Roads Scholarship Program is a financial

More information

Maine s Children s Scholarship Fund Program Guidelines. I. Purpose: Mission of the Maine s Children s Scholarship Fund

Maine s Children s Scholarship Fund Program Guidelines. I. Purpose: Mission of the Maine s Children s Scholarship Fund Maine s Children s Scholarship Fund Program Guidelines I. Purpose: Mission of the Maine s Children s Scholarship Fund We offer scholarships to low-income Maine families who send their child to a public,

More information

The Kaiser Permanente Bridge Program Application

The Kaiser Permanente Bridge Program Application The Kaiser Permanente Bridge Program Application Kaiser Foundation Health Plan of Georgia, Inc. APP/CB-080500 11/08 Instructions ISTRUCTIOS: Please print clearly using a blue or black ink pen. If the question

More information

Florida Association of Destination Marketing Organizations Dave Warren Scholarship Fund

Florida Association of Destination Marketing Organizations Dave Warren Scholarship Fund Florida Association of Destination Marketing Organizations Dave Warren Scholarship Fund Scholarship Application Form Application Deadline: January 15, 2014 THE COMMUNITY FOUNDATION OF SARASOTA COUNTY,

More information

STEP 4. Submit Your Application Mail (or deliver in person to the front desk) the above documents together to:

STEP 4. Submit Your Application Mail (or deliver in person to the front desk) the above documents together to: Application Deadlines: For returning applicants: Applications for the school year must be received by August 1, 2015. For new applicants: Applications will be accepted at any time. STEP 1. STEP 2. Complete

More information

UNDERGRADUATE STUDIES BURSARY APPLICATION FORM - UNEMPLOYED DIRECT LEARNER YEAR 2015/16

UNDERGRADUATE STUDIES BURSARY APPLICATION FORM - UNEMPLOYED DIRECT LEARNER YEAR 2015/16 UNDERGRADUATE STUDIES BURSARY APPLICATION FORM - UNEMPLOYED DIRECT LEARNER YEAR 2015/16 Apply on or before: 15 August 2015 for support during the next academic year Use block letters to complete the form.

More information

Non-Auditioned Scholarships/Awards

Non-Auditioned Scholarships/Awards Non-Auditioned Scholarships/Awards 2015 GENERAL INFORMATION AND GUIDELINES The Conservatory offers a large number of honours and awards. Teachers should enter as many deserving students as possible to

More information

MARYLAND SENIOR PRESCRIPTION DRUG ASSISTANCE PROGRAM ENROLLMENT APPLICATION

MARYLAND SENIOR PRESCRIPTION DRUG ASSISTANCE PROGRAM ENROLLMENT APPLICATION MARYLAND SENIOR PRESCRIPTION DRUG ASSISTANCE PROGRAM ENROLLMENT APPLICATION Dear Applicant: The Maryland Senior Prescription Drug Assistance Program (SPDAP) is pleased to provide you with the enclosed

More information

The Algoma Community Legal Clinic in Partnership with ODSP/OW Recipients and the Sault Ste. Marie Community Soup Kitchen

The Algoma Community Legal Clinic in Partnership with ODSP/OW Recipients and the Sault Ste. Marie Community Soup Kitchen The Algoma Community Legal Clinic in Partnership with ODSP/OW Recipients and the Sault Ste. Marie Community Soup Kitchen Submission to the Task Force on Social Assistance Review 2011 Introduction: We would

More information

Serving the Future with Your Gifts Today

Serving the Future with Your Gifts Today The First Baptist Foundation Serving the Future with Your Gifts Today Instructions for Completing the First Baptist Foundation Scholarship Application 1. All information must be returned to our office

More information

Local 804 Pension Plan

Local 804 Pension Plan Local 804 Pension Plan A guide to your pension plan benefits Union Benefit Plans Services Contact Contact us If you have any questions about the plan, please contact the plan administrator: Union Benefit

More information

Protected B when completed Canada Revenue Agence du revenu Agency du Canada SUSAN B

Protected B when completed Canada Revenue Agence du revenu Agency du Canada SUSAN B Canada Revenue Agence du revenu Agency du Canada T1 GENERAL 2014 Income Ta and Benefit Return Complete all the sections that apply to you. For more information, see the guide. Identification First name

More information

OPEN ENROLLMENT FOR HEALTH BENEFITS 2014 ADJUNCT FACULTY

OPEN ENROLLMENT FOR HEALTH BENEFITS 2014 ADJUNCT FACULTY OPEN ENROLLMENT FOR HEALTH BENEFITS 2014 ADJUNCT FACULTY OPEN ENROLLMENT begins Monday, August 25, 2014 from 11:30AM to 4 PM in the new pavilion. Representatives from Independence Blue Cross, Delta Dental,

More information

New England Conservatory. 2015-2016 Application for Financial Aid and Scholarships for Undergraduate and Graduate Students

New England Conservatory. 2015-2016 Application for Financial Aid and Scholarships for Undergraduate and Graduate Students New England Conservatory 2015-2016 Application for Financial Aid and Scholarships for Undergraduate and Graduate Students FINANCIAL AID OFFICE The Financial Aid Office at New England Conservatory is committed

More information

2016-2017 APPLICATION FOR ADVANCED LEARNING BURSARY

2016-2017 APPLICATION FOR ADVANCED LEARNING BURSARY Office use only Date received: 2016-2017 APPLICATION FOR ADVANCED LEARNING BURSARY for an Advanced Learning Loan) We understand that coming to college can be a big financial commitment, so to encourage

More information

FINANCIAL AID APPLICATION for ECE, HYC, Camp, and JCC Maccabi Games and ArtsFest

FINANCIAL AID APPLICATION for ECE, HYC, Camp, and JCC Maccabi Games and ArtsFest FINANCIAL AID APPLICATION for ECE, HYC, Camp, and JCC Maccabi Games and ArtsFest Financial Aid Checklist In order for this application to be reviewed, you must have already submitted all registration forms

More information

HENRY COUNTY GENERAL ASSISTANCE APPLICATION 106 N. Jackson, Mt. Pleasant, IA 52641 319-385-0790 Fax: 319-385-8016

HENRY COUNTY GENERAL ASSISTANCE APPLICATION 106 N. Jackson, Mt. Pleasant, IA 52641 319-385-0790 Fax: 319-385-8016 Appointment: HENRY COUNTY GENERAL ASSISTANCE APPLICATION 106 N. Jackson, Mt. Pleasant, IA 52641 319-385-0790 Fax: 319-385-8016 Date: Name: Phone: Current Address: From: / / to / / (street) (city) (state)

More information

Student Money Advice & Rights Team (SMART) Hardship Fund 2015/16

Student Money Advice & Rights Team (SMART) Hardship Fund 2015/16 Student Money Advice & Rights Team (SMART) Hardship Fund 2015/16 Please retain guidance notes for your information. The NEW SMART Hardship Fund (SHF) is available from 9 th November 2015 to provide extra

More information

Where you see this symbol you need to be aware of the important information in the section you are completing and should review it in full.

Where you see this symbol you need to be aware of the important information in the section you are completing and should review it in full. 20+ Childcare Support 2015/2016 Registration Form This childcare registration form must be completed by both the student and childcare provider before an application can be made for childcare support.

More information

Columbia Parks & Recreation Department Financial Assistance Program

Columbia Parks & Recreation Department Financial Assistance Program Columbia Parks & Recreation Department Financial Assistance Program Goal: The Financial Assistance Program was created to provide economically disadvantaged individuals access to recreational facilities

More information

CHILD CARE GRANT SPRING 2016, SUMMER 2016

CHILD CARE GRANT SPRING 2016, SUMMER 2016 1130 Women s Resource /Returning Adult Program Lansing Community College P. O. Box 40010 Lansing, Michigan 48901 7210 Phone: (517) 483 1199 Fax: (517) 483 9645 http://www.lcc.edu/wrc email: wmnrsrc@lcc.edu

More information

Graduate Student Financial Need Assessment Form (NAF) Summer 2014 (May 1 August 30)

Graduate Student Financial Need Assessment Form (NAF) Summer 2014 (May 1 August 30) I am applying for: Graduate Student Financial Need Assessment Form (NAF) Summer 2014 (May 1 August 30) Bursary (before July 5 th or an appointment with a financial aid counsellor is required) Work Study

More information

Submitting your Financial Aid Application Online

Submitting your Financial Aid Application Online Documentation After completing the online application you will need to forward the following income documentation: 1) Page 1 and 2 of your 2013 US Individual Tax return (Form 1040, 1040A,or 1040EZ) 2)

More information

Other Important Information. Apply On-Line!

Other Important Information. Apply On-Line! Application Form 101 4555 Kingsway, Burnaby, B.C. V5H 4V8 Phone: 604 433-2218 Toll-Free: 1-800 257-7756 Fax: 604 439-4729 Purpose of this Form This form collects personal information in accordance with

More information

WORKSHEET. Child Care Scholarship -2014

WORKSHEET. Child Care Scholarship -2014 Child Care Scholarship -2014 The Child Care Scholarship Fund is an NYU program established to assist eligible fulltime faculty, administrators, and research staff with child care expenses for children

More information

FREE CARE APPLICATION ATTACHMENT

FREE CARE APPLICATION ATTACHMENT FREE CARE APPLICATION ATTACHMENT PLEASE REMEMBER THIS IS NOT AN INSURANCE PLAN IT IS A CHARITABLE CARE PROGRAM AND THERE IS NO ESTABLISHED FUND. THERE IS NO MONEY EXCHANGED FOR SERVICES BY ANY CMC PHYSICIAN/PRACTICE.

More information

INTERNATIONAL STUDENT EXCHANGE PROGRAMS

INTERNATIONAL STUDENT EXCHANGE PROGRAMS INTERNATIONAL STUDENT EXCHANGE PROGRAMS Dear Congratulations! International Student Exchange Programs (ISEP) is pleased to offer you an opportunity to study at In order to accept your placement and to

More information

Application for Provincial Training Allowance 2016-2017 Office Use Only APPLICANT DEMOGRAPHIC APPLICANT CATEGORY. Sask. Health Services Number (HSN)

Application for Provincial Training Allowance 2016-2017 Office Use Only APPLICANT DEMOGRAPHIC APPLICANT CATEGORY. Sask. Health Services Number (HSN) Application for Provincial Training Allowance 2016-2017 Office Use Only Date Received File Number Bar Code PSE Number Application Number APPLICANT DEMOGRAPHIC Social Insurance Number (SIN) No SIN Sask.

More information

*You must submit a new application for each semester (fall or spring) in order to be considered for scholarships for that semester.

*You must submit a new application for each semester (fall or spring) in order to be considered for scholarships for that semester. Board of Directors President Susan Ovitt Chaffey Joint Union High School District Immediate Past President James Touchstone Jones & Mayer Vice President Loren Sanchez Secretary Ken Galasso Sierra Realty

More information

Future to Discover Learning Accounts and Explore Your Horizons Project Consent Forms

Future to Discover Learning Accounts and Explore Your Horizons Project Consent Forms Future to Discover Learning Accounts and Explore Your Horizons Project Consent Forms Future to Discover (FTD) is a research project. It is designed to help more New Brunswick students go on to post-secondary

More information

The following requirements must be met before your loan application will be considered:

The following requirements must be met before your loan application will be considered: Student Account Services Short Term Loan Program Information Packet and Loan Application The purpose of the Short Term Loan Program is to assist students in meeting temporary short term financial needs.

More information

Please complete this form and return it with original tax slips received.

Please complete this form and return it with original tax slips received. INCOME TAX INFORMATION Don Allen & Associates Inc. files two tax returns in the year of your bankruptcy one from January 1 of the year of bankruptcy to the date of your bankruptcy. This is called a Prebankruptcy

More information

Emeriti Retirement Health Solutions Qualified Medical Expense Claim Form Effective January 1, 2012

Emeriti Retirement Health Solutions Qualified Medical Expense Claim Form Effective January 1, 2012 1 Emeriti Retirement Health Solutions Qualified Medical Expense Claim Form Effective January 1, 2012 Please use this Claim Form to submit claims for the reimbursement of Qualified Medical Expenses, otherwise

More information

2016 Scholarship Application Timeline

2016 Scholarship Application Timeline 2016 Scholarship Application Timeline Applications Process: April 1 - May 16, 2016 Interview Notifications Sent By: May 17 th via email Scholarship Interviews: Friday, May 20, 2016 Selection Notifications

More information

Maine Roads Scholarship Program CDA Information 2015-2016

Maine Roads Scholarship Program CDA Information 2015-2016 www.muskie.usm.maine.edu/maineroads PLEASE READ BEFORE COMPLETING APPLICATION FORM Maine Roads Scholarship Program CDA Information 2015-2016 I. DEFINITION ki i The Maine Roads Scholarship Program is a

More information

JAMVAT APPLICATION FORM COVER ACADEMIC YEAR 2012-2013

JAMVAT APPLICATION FORM COVER ACADEMIC YEAR 2012-2013 JAMVAT APPLICATION FORM COVER ACADEMIC YEAR 2012-2013 Guidelines for completing the application form: Complete using black or blue ink. Complete forms in BLOCK CAPITAL, legibly and accurately. Please ensure

More information

Immigration Fee Waivers

Immigration Fee Waivers Education for Justice Fact Sheets By Mid-Minnesota Legal Aid and Legal Services State Support Fall 2011 Education for Justice P.O. Box 14246 St. Paul, MN 55114 e4j@mylegalaid.org Immigration Fee Waivers

More information

Carroll College Matched Education Savings Account Application

Carroll College Matched Education Savings Account Application PERSONAL INFORMATION Name: Social Sec. No. (last four digits): Gender: Female Male Date of Birth: / / Ethnicity: African American Caucasian Latino or Hispanic Asian, Pacific Islander Native American Other

More information

Student Financial Assistance Guide and Application. For classes beginning any time between August 1, 2010 and July 31, 2011

Student Financial Assistance Guide and Application. For classes beginning any time between August 1, 2010 and July 31, 2011 2010-2011 Student Financial Assistance Guide and Application For classes beginning any time between August 1, 2010 and July 31, 2011 You can apply online Go to www.studentloan.pe.ca You do not need high

More information

2015-2016 Dependent Verification

2015-2016 Dependent Verification V6- DEP FORM 2015-2016 Dependent Verification Your 2015-2016 Free Application for Federal Student Aid (FAFSA) was selected for review in a process called verification. Northern must compare information

More information

EVIT COSMETOLOGY & AESTHETICS PACKET

EVIT COSMETOLOGY & AESTHETICS PACKET DATE PACKET RECEIVED TIME INITIALS EVIT COSMETOLOGY & AESTHETICS PACKET Thank you for applying to the EVIT Cosmetology program. Your packet must contain all of the following items and be delivered to the

More information

REDUCE OR ELIMINATE YOUR STATE CHILD SUPPORT ARREARS!

REDUCE OR ELIMINATE YOUR STATE CHILD SUPPORT ARREARS! XAMP FRIEND OF THE COURT Renae Topolewski ASSISTANT FRIEND OF THE COURT Edward V. Messing, Jr. ST. CLAIR COUNTY FRIEND OF THE COURT 31 st Judicial Circuit 201 McMorran Blvd., Room 1600 Port Huron, Michigan

More information

PHYSICAL or OCCUPATIONAL THERAPY MAJORS AND. PHYSICAL or OCCUPATIONAL THERAPY ASSISTANT SCHOLARSHIP APPLICATION:

PHYSICAL or OCCUPATIONAL THERAPY MAJORS AND. PHYSICAL or OCCUPATIONAL THERAPY ASSISTANT SCHOLARSHIP APPLICATION: Illinois Elks Children s Care Corporation PO Box 222 Chatham, IL 62629-0222 December, 2014 PHYSICAL or OCCUPATIONAL THERAPY MAJORS AND PHYSICAL or OCCUPATIONAL THERAPY ASSISTANT SCHOLARSHIP APPLICATION:

More information

Application Guide 15/16. www.gov.nl.ca/studentaid

Application Guide 15/16. www.gov.nl.ca/studentaid Application Guide 15/16 www.gov.nl.ca/studentaid INTRODUCTION 2 APPLYING FOR ASSISTANCE 2 How to Apply 2 If not Borrowing for a Semester 2 Applying for Assistance for Second Semester Only 2 Assistance

More information

TAX DEFERRAL INFORMATION AND INSTRUCTION SHEET

TAX DEFERRAL INFORMATION AND INSTRUCTION SHEET CECIL COUNTY, MARYLAND OFFICE OF FINANCE 200 CHESAPEAKE BLVD, STE. 1100 ELKTON, MARYLAND 21921 TAX DEFERRAL INFORMATION AND INSTRUCTION SHEET The Annotated Code of Maryland, Tax-Property Article 10-204

More information

Eligibility and Requirements THE JOHN R. KERNODLE, JR. MEMORIAL SCHOLARSHIP

Eligibility and Requirements THE JOHN R. KERNODLE, JR. MEMORIAL SCHOLARSHIP Eligibility and Requirements THE JOHN R. KERNODLE, JR. MEMORIAL SCHOLARSHIP The John R. Kernodle, Jr. Memorial Scholarship was established in 1996 by a group of Guilford County citizens in memory of John

More information

FLORIDA STATE ELKS ASSOCIATION HOPE SCHOLARSHIP GENERAL INFORMATION

FLORIDA STATE ELKS ASSOCIATION HOPE SCHOLARSHIP GENERAL INFORMATION GENERAL INFORMATION Eligibility: To be eligible to apply for a scholarship award from the Hope Scholarship Fund, you must: 1. Be a student in the graduating class of a high school or its related equivalent.

More information

Program Description Program Goals: Application Deadline Application / Selection Process

Program Description Program Goals: Application Deadline Application / Selection Process Advanced Placement Magnet Application Chapel Hill High School (Application for the 2015-2016 School Year) Program Description: Chapel Hill High School is committed to expanding the Advanced Placement (AP)

More information

AND CONDITIONS OF THE TISO FOUNDATION BURSARY

AND CONDITIONS OF THE TISO FOUNDATION BURSARY Closing date: 30 October General Information Incomplete applications will not be considered Applicants must be black as defined by the BBBEE codes of good practice (Black, Coloured or Indian) No applications

More information

BAGSF Mission. BAGSF Scholarships: (All applicants must apply using the most current year s scholarship application.)

BAGSF Mission. BAGSF Scholarships: (All applicants must apply using the most current year s scholarship application.) BAGSF Mission Bay Area Gardener s Scholarship Foundation strives to promote the educational attainment achievement of all diverse students in the Bay Area by among other things, conducting public discussions,

More information

NEW COLLEGE LANARKSHIRE Student Handbook Bursary/Educational Maintenance Allowance (EMA) 2015-2016

NEW COLLEGE LANARKSHIRE Student Handbook Bursary/Educational Maintenance Allowance (EMA) 2015-2016 NEW COLLEGE LANARKSHIRE Student Handbook Bursary/Educational Maintenance Allowance (EMA) 2015-2016 1 P a g e Contents Introduction... 4 Education Maintenance Allowance (EMA)... 5 What is Education Maintenance

More information

Rio Homes Permanently Affordable Homes Application Process

Rio Homes Permanently Affordable Homes Application Process Rio Homes Permanently Affordable Homes Application Process Thank you for your interest in the third phase of the Rio Homes. This partnership between AZNORTH Development, Inc. and the City of Flagstaff

More information

MALIK ACADEMY AND AL BUSTAN PRESCHOOL FINANCIAL AID/REDUCED TUITION PROGRAM

MALIK ACADEMY AND AL BUSTAN PRESCHOOL FINANCIAL AID/REDUCED TUITION PROGRAM MALIK ACADEMY AND AL BUSTAN PRESCHOOL FINANCIAL AID/REDUCED TUITION PROGRAM Dear Parent/Guardian: Sending children to private school can be expensive. In order to make our school affordable to as many

More information

1040 U.S. Individual Income Tax Return 2015

1040 U.S. Individual Income Tax Return 2015 Form Department of the Treasury - Internal Revenue Service (99) 1040 U.S. Individual Income Tax Return 2015 OMB. 1545-0074 For the year Jan. 1-Dec. 31, 2015, or other tax year beginning, 2015, ending,

More information

LAGRANGE COUNTY COMMUNITY FOUNDATION SCHOLARSHIP APPLICATION

LAGRANGE COUNTY COMMUNITY FOUNDATION SCHOLARSHIP APPLICATION LAGRANGE COUNTY COMMUNITY FOUNDATION SCHOLARSHIP APPLICATION SECTION 1 MICHAEL AND KAREN STRAWSER - WOLCOTT MILLS TRADE SCHOOL SCHOLARSHIP AWARD: 1. $500 2. One-time payment for the fall enrollment 3.

More information

2013 ENVIRONMENTAL LITIGATION GROUP (ELG) SCHOLARSHIP POLICIES SUBMISSION DEADLINE: MARCH 1, 2013

2013 ENVIRONMENTAL LITIGATION GROUP (ELG) SCHOLARSHIP POLICIES SUBMISSION DEADLINE: MARCH 1, 2013 2013 ENVIRONMENTAL LITIGATION GROUP (ELG) SCHOLARSHIP POLICIES SUBMISSION DEADLINE: MARCH 1, 2013 1. ACADEMIC QUALIFICATIONS: It is expected that applicants in high school will have a 3.5 grade point average

More information

Healthy Kids Annual Renewal Application

Healthy Kids Annual Renewal Application Healthy Kids Annual Renewal Application Application Due By: It is time to renew your Healthy Kids health care coverage. If you would like it in another language, please call (415) 777-9992. It is time

More information

Gaston County Family YMCA

Gaston County Family YMCA Thank you for your interest in the. A Scholarship application is attached. Please complete this entire form, and carefully note the documentation requirements when preparing your application. (Applications

More information