Application for Awards, Bursaries and Scholarships

Name of award for which you are applying: Name of College program for which you have been accepted/registered: To be eligible for awards that specify Aboriginal ancestry as part of the criteria, please indicate below: Inuit Non-status Metis Treaty/Status

Student information: Student name: Student #: Current address: City: Province: Postal code: Home phone: Cell phone: Date of Birth (dd/mm/yy): Email: Social insurance number: Permanent address (if different from above): City: Province: Postal code:

Educational background: Name of high school: Grade completed: Year:

Family information: If applicable, is spouse: Working Attending school At home Names and ages of dependent children: Name: Age: Name: Age: Name: Age: Name: Age:

(If you need more space to write, please attach additional paper to this form) If applicable, please indicate how you meet the special criteria for this award.

Red River College - Student Services Notre Dame Campus Exchange District Campus D101–2055 Notre Dame Ave., Winnipeg, MB R3H 0J9 P104-160 Princess St., Winnipeg, MB R3B 1K9 P: 204.632.2327 | F: 204.697.0584 P: 204.632.2327 | F: 204.949.9105 Last modified July 2015 Application for Awards, Bursaries and Scholarships

Is there any additional information of which you would like us to be aware?

I certify that the information given on this application form is complete and true in every respect. I understand that as an award applicant/recipient, the information on this application may be provided to the Award Selection Committee/Donor

Student signature Date (dd/mm/yy)

If financial need is a selection criterion, please complete the FINANCIAL INFORMATION section below.

Financial information (during this year’s enrolment period) Monthly expenses Amount ($) Monthly resources Amount ($) Housing/Rent Employment income Food Spouse’s income Utilities EI/Employment MB Transportation Child Tax Benefit Day care Parental contribution Debt payments Sponsorship Miscellaneous (clothing, recreation, etc.) Other Total monthly costs: Total monthly resources:

Other expenses: Amount ($) Other resources: Amount ($) Outstanding tuition Canada Student Loan Outstanding books Manitoba Student Loan Other Total: Total:

Please list any exceptional expenses you (or your spouse, where applicable) have or expect to have during the academic year.

If you (or your spouse, where applicable) own a vehicle, please indicate the following: Make: Model: Year:

Please list the type and cash value of all bank accounts, bonds, trust accounts, etc. Bank and account type Value Bank and account type Value (chequing/savings) (chequing/savings)

This section to be completed by parent(s) unless the applicant: • Has been working full-time for two or more years OR • Has been out of high school for four or more years OR • Is married, living common-law, or has dependent children of their own.

From previous year Mother Father Taxable income $ $ Non-taxable income $ $ Self-employment earnings $ $ Total: $ $

Names and ages of dependent , including applicant: Name: Age: Name: Age: Name: Age: Name: Age:

For more information on our student awards and financial aid please visit rrc.ca/awards Mail or drop off a completed form to: Student Service Centre, Notre Dame Campus, D101-2055 Notre Dame Ave., Winnipeg, MB R3H 0J9