2020-ford-heathcote-hughes-application--fillable

Department of English and Film Studies, University of Alberta Bursary Application Form CATHERINE & LOUISE FORD AWARD and/or THE LESLEY HEATHCOTE LIBRARIANSHIP BURSARY; THE VANESSA HUGHES MEMORIAL AWARD General Eligibility Requirements: • In order for funds to be broadly distributed, no undergraduate student may hold more than one University of Alberta major bursary or award in any one year The minimum value of a major award is currently $5000 • The awards covered by this application are offered contingent upon students proceeding with their programs at this University, and the full value is payable only when students are in full-time attendance at the University Students who are registered part-time or in one term will have the value prorated • Only successful applicants will be notified Instructions Download this PDF form, open file in Adobe Acrobat Reader and fill it out, save completed form on your device Upload cover letter and the saved application to the Google Form Document (UofA login required) Applications must be received no later than May 15, 2020 Late applications will not be considered A Personal/Academic Information (please print) Surname Usual First Name Current Address Phone Number Middle Initial(s) City 7-digit UofA ID Number Province Postal Code Email address Year of Program completed (as of May 2020) □ □ □ □ Program of Study B Budget Information This section is to be answered by all students applying for awards based on financial need Please complete your calculations projecting for the 8-month period from September 2020 to April 2021 Expenses Rent and Utilities Food and Personal Care Clothing Transportation Child Care Tuition, Fees, Books Other Expenses (specify) Total Expenses How Much? Resources Savings Part-time earnings during school Contribution from parents/spouse Investments (please specify) Other income (tax rebate, family allowance, etc.) Scholarship/Bursaries confirmed for 2019/20 How Much? Total Resources Amount required Total Resources $ Total Required $ minus Total Expenses $ equals Will you be applying for a student loan? □ Yes □ No What is your total indebtedness to the Students’ Finance Board as of April 30, 2019? $ C Signature (This application must be signed) Signature Date The personal information requested on this form is collected under the authority of the Universities Act and Section 32(c) of the Alberta Freedom of Information and Protection of Privacy Act and will only be used to determine eligibility for the two awards noted at the top of this form I HEREBY CERTIFY that the information given above is complete and true in all respects and that the Student Awards Office is authorized to access transcripts of my academic record I agree to abide by the terms and conditions of the award as published by the University of Alberta, and in the General Faculties Council Policy Manual I understand that if I am granted an award, my name, address, and program information may be reported to the donor of the award and/or used for program recruiting or advertising purposes Questions regarding the collection, use or disclosure of this information should be addressed to: The FOIPP Liaison Officer, Humanities 3-9, Department of English, University of Alberta; Phone: (780) 492-7839; Fax: (780) 492-8142