Post-Secondary Education Assistance Application Form

POST-SECONDARY EDUCATION ASSISTANCE APPLICATION FORM

Continuing Students (For Students currently being sponsored by Misipawistik Cree Nation and requiring continued sponsorship)

In preparation for the upcoming year we require the following information. Please complete as accurately as possible and return to our office along with your most recent transcript and a copy of a signed Release of Information Form from your Educational Institution. Applications will not be processed until all documents are received.

Continued sponsorship is based on:

1) Accurately completed application form and copy of a signed Release of Information Form from your Educational Institution.

2) A review of your transcript which must indicate positive effort and grades that reflect success.

Name:______________________________________________________ Treaty # __________

Mailing address: ________________________________________________________________

Phone #: ________________________________SIN #: ________________________________

Spouse or Partner: _________________________________SIN # __________________

# of Dependants: ____________

Names, ages, grades of dependants living with you:

____________________________ ____________________ ____________

_____________________________ _____________________ ___________

_____________________________ _____________________ ___________

_____________________________ _____________________ ___________

Institution attending: ____________________________________________________________

Program of study: ______________________________________________________________

Length of program: ____________________ Year in Program:________________

Expected graduation date: ___________________________

Where do you want cheques sent?

Same address as above Median Credit Union Act # and type__________________

Where do we send correspondence?

Same address as above or _____________________________________________

Is your spouse:

going to school ? Full time Part time NO

working ? Full time Part time NO

First day of classes for the upcoming academic year: ___________________________________

Last day of classes for the upcoming academic year: ___________________________________

Contact at school:

Name: __________________________________

Title: ____________________________________

Phone # ____________________________

Additional information: __________________________________________________________

_____________________________________________________________________________

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