STUDENT AWARDS & FINANCIAL AID

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Ira G. Needles Hall (NH) 2018-19
Waterloo, Ontario, Canada N2L 3G1
519-888-4567 ext. 33583 | safa.uwaterloo.ca
Full-time Bursary
Application

Section A: Bursary Information

Specify which bursary you applying for: University of Waterloo Full-time Bursary
Other (specify)

Which terms are you applying for (choose all that apply): Fall Winter Spring
(must match your OSAP or other provincial aid assessment)
Have you applied for OSAP or other provincial student aid? Yes No
If yes, specify which province: If outside Ontario, attach a copy of your loan assessment.

Section B: Personal Information

Student ID Number

Last Name First Name

Address City:

Province Postal Code Region/County:

Citizenship: Canadian Permanent Resident

Voluntary declaration – Are you an Indigenous person – First Nation, Métis or Inuit? Yes No

Are you applying for an Ontario First Generation Bursary? Yes No

If yes, have your parents ever attended post-secondary studies, in any program, full or part-time, in or outside of Canada?
Yes No

OSAP Status Single Dependent Single Independent Married/Common Law Sole Support Parent

If you have dependent children, indicate number of children and their ages:
If you are single dependent, married or common law and have not applied for OSAP, attach an explanation and the
Supplemental Bursary Information form. For out of province students, please refer to the form to see if it is required.
If you are single independent and have not applied for OSAP, attach an explanation. (You do not need to complete the
Supplemental Bursary Information form.)

Section C: Academic Information

Campus: University of Waterloo Renison St. Jerome’s Online studies

Level of Study: Undergraduate Graduate Form of Study: Regular Co-op

Academic Level: Number of courses: Academic Average:

Faculty: Department/Major:

Indicate any extra-curricular activities you are involved with. Attach a separate sheet describing your involvement.
Warrior Community Campus Recreation and Federation
Athletics Volunteer Volunteer Campus Clubs of Students

For office use only:

Section D: Financial Information
Use the same study period as your OSAP or other provincial financial aid application. Any discrepancies may result in
changes to your application. Each student is expected to make a contribution from their summer or work term earnings.
Bursaries are based on reasonable costs.

Pre-Study Period Budget Study Period Budget

(16 weeks before your study period began or 9 weeks
before if you finished high school last June) Study period dates:

Pre-study period dates: From: To:

From: To: Accommodations during your study period:

I was in school full-time during my pre-study period With parents

and do not need to complete the pre-study budget.
Other – specify:
Accommodations during your pre-study period:
Income and Resources
With parents Your total pre-study savings from Line C
Other – specify Estimated study period net employment income
Income Other study period income
A (Government income, donship, etc.)
Pre-study net income
RESP (amount using this study period)
Expenses
(Do not include computers or car insurance and repairs)
Parent or spousal contribution
Rent and utilities
Scholarships and awards
Phone and internet Assets (e.g. savings, RRSP, etc.)

Food OSAP or other provincial aid

Local transportation Total study period resources D

Expenses
Personal care and clothing (Do not include computers or car insurance and repairs)

Laundry Tuition and compulsory fees

Entertainment and recreation
Childcare
Uninsured medical or dental
(receipts required)
Other expenses
(receipts required)
Total Pre-Study Expenses
(Line A minus Line B)
This is your saving from your Pre-Study Period
For office use only
Books and supplies
Rent and utilities/ residence
Phone and internet
Food / meal plan
Local transportation
Personal care, clothing, and laundry
Entertainment and recreation
B
Childcare
C Uninsured medical or dental
(receipts required)
Other expense (receipts required)

Total Expenses E

(Line E minus Line D)

Bursary Amount Requested
If this amount is negative, you do not have need.
Dec 2018
Section E: Applicant’s Declaration and Consent

I authorize the University of Waterloo to release a copy of this application to the appropriate awards selection committee(s)
and to the award donor, including my academic record and copies of any information attached to this application.

In order to adjudicate my application for a university or college bursary or award, I authorize the University of Waterloo to
release my financial need information and University of Waterloo bursary decision to the appropriate award selection
committee(s).

I understand that I am responsible for providing all required documentation as indicated on this application or as directed by
the University of Waterloo Student Awards & Financial Aid office. I understand that if I do not submit the required
documentation or information I may not be considered for a bursary.

I understand that all income, assets and other resources will be verified using my OSAP application information, if
applicable.

I understand that the collection of personal information provided on this application or accompanying documentation is
used solely for the purpose of determining my eligibility for bursary assistance and verifying income information against
my OSAP file.

The Ministry of Advanced Education and Skills Development (the Ministry) has provided the University of Waterloo with
funding to administer several bursaries i.e. Indigenous Student Bursary, Ontario First Generation Bursary, etc. As a
condition of this funding, University of Waterloo is required to make reports to the Ministry of your contact information, the
amount of bursary you receive, the date it was awarded, your study period and information related to your eligibility for the
bursary. This personal information will be used by the Ministry to administer and finance the bursary. It will also be used to
establish the minimum amount of student aid University of Waterloo is required to provide under the Student Access
Guarantee (the Guarantee) and to administer and finance the Guarantee. If you apply for OSAP, this personal information
will be used to update your OSAP application or award, including your declared income.

Administration includes public reporting on the administration and financing of the bursary and the Guarantee; monitoring
and auditing University of Waterloo or its authorized agents to ensure that we are administering the bursary appropriately;
conducting risk management, error management, audit and quality assessment activities; and conducting policy analysis,
evaluation and research related to all aspects of student assistance. Financing includes planning, arranging or providing
funding of the bursary and the Guarantee. The Ministry administers the bursary and the Guarantee under the authority of
the Ministry of Training, Colleges and Universities Act, R.S.O. 1990, c. M.19 as amended.

I declare that all of the information that I have given on this form is true and accurate. If any information is inaccurate, I
understand that any bursary awarded may be reassessed and/or withdrawn.

Student Signature Date

Please mail or drop off completed applications to:

Student Awards & Financial Aid,

University of Waterloo
2nd Floor Needles Hall
Waterloo, ON
Canada
N2L3G1

Dec 2018