ࡱ> ikhe bjbj0i0i 8bRiRi& & 8,1*55KKK:::y*{*{*{*{*{*{*,x/{*&::&&{*KK*!!!&LKKy*!&y*!!R!(<)K!ir])e**0*{)B//<)/):J! ~:::{*{* *:::*&&&&/:::::::::& Y : Financial Need Based Awards Assessment Douglas Fullerton Urban Studies Award Student InformationLast Name First NameStudent numberCurrent Address (while attending Ӱԭ University)City, town, or post officePostal codeArea code and telephone number-Permanent Home Address (if different from above): Citizenship Status ( Canadian Citizen ( Permanent Resident ( Protected Person ( VISA Check the statement below that best describes your residency situation: ( You have always resided in Ontario, or Ontario is the last province you resided in for 12 consecutive months without being a full-time post-secondary student ( Your spouse has always resided in Ontario, or Ontario is the last province your spouse resided in for 12 consecutive months without being a full-time post-secondary student ( Ontario is the last province your parent(s), step-parent(s), legal guardian(s), or official sponsor(s) has resided in for 12 consecutive months ( You now live in Ontario, but the above statements do not apply to you Program nameMajor or concentrationProgram Year (eg. Yr2, Yr3, Y4)Financial Need AssessmentWill you be receiving OSAP assistance for this Academic Year? ( Yes ( NoWill you be receiving government sponsored student aid from another province for this Academic Year: ( Yes ( No Please specify:____________________________________________Students DeclarationI authorize Ӱԭ University to release a copy of this application to the appropriate awards selection committee(s) and to the award donor, including my academic record and financial need information in order to adjudicate my application for an award. If requested, I agree to provide the Awards Office with any documentation necessary to verify the information on this. I declare that the above information is true and accurate. If any information is inaccurate, I understand that an award may be reassessed and/or withdrawn.Signature of Student Date Financial Need Budget Sept. April (8 month student budget) ExpensesValueResourcesValueTuition Savings (at the start of your study period that will be contributed towards your budget for this Academic Year)Books/Supplies Parents ContributionResidence Fees Spouse/Relatives/Friends ContributionOther related educational costs (specify) eg. co-op feeScholarships/BursariesRent  X 8 months =Government Student Loans, Grants, BursariesFood  X 8 months =Net Part-time Earnings Utilities X 8 months = Other (specify)Telephone & Internet Costs  X 8 months =Total Resources$Personal Items  X 8 months =Clothing  X 8 months =Laundry  X 8 months = Transportation (local) X 8 months =Transportation (trips home)  Entertainment  X 8 months =Other (specify) Total Expenses $Calculated Need Total Expenses minus Total Resources$ At Ӱԭ University, we recognize and respect the importance of privacy. Personal information that we collect is kept confidential. In accordance with section 41 of the Freedom of Information and Protection of Privacy Act, Ӱԭ University will only use the information in its custody or control in the following circumstances: where the individual identifies the particular information and consents to its use; for the purpose for which it was collected or a consistent purpose (i.e. a purpose which the individual might have reasonably expected).     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