VAT SCHOLARSHIP APPLICATION FORM 2016 - 17

DEADLINE: WEDNESDAY, NOVEMBER 30, 2016 AT 5:00PM

Applicant’s First Name: ______Last Name: ______

Addres______

City: ______Province: ______Postal Code: ______

Telephone: ______E-mail: ______

School attending in 2016-2017: ______

Please select one of the following scholarship categories:

Academic Excellence: for 1st year students (Permanent Residents or Citizens) enrolled in a college/university in Ontario. Selection is based on 1) high school grades, 2) awards/achievements, 3) recommendations from teachers, principals, 4) Have or have not received any scholarships before? If yes, specify what kind and year(s) received 5) Essay.

Community Service Excellence/Bursary: for any students (Permanent Residents or Citizens) enrolled in colleges or universities in Ontario. Selection is based on 1) Volunteer work, recommendations from relevant charitable supervisors, 2) Recommendation from teachers/supervisors, awards/achievements, 3) Number of years of service, type of work, 4) Have or have not received any scholarship / bursaries before? If yes, specify what kind and year(s) 5) Essay.

Required documents to be submitted with application:

1. Academic record (official high school transcript if applying for Academic Excellence category) and summary in MS Word with the following:

  • Grade 12 Math
  • Grade 12 English
  • Grade 12 - Top grades for 5 additional subjects other than Grade 12 Math and English

2. Copy of awards & achievements

3. Reference letters (2+)

4. Short essay, max 500 words, in Vietnamese or English about "Youth role and contributionin building a strong just society". Preference will be given to essays written in Vietnamese, but NOT absolutely required.

5. Financial Need Assessment Form - Only applicable if applying for the VAT Bursary

6. Picture (to be used for publication if selected as a recipient)

I (we) guarantee that all information provided herein are true.

Applicant’s Signature: ______Date:______

Nominator’s Full Name: ______Title:______

Phone Number: ______Email: ______

Nominator’s Signature: ______Date:______

Please scan and send application package to

You will receive written confirmation via email once your application has been received.

For general inquiries, please contact Vietnamese Association, Toronto at 416-536-3611 or

Financial Need Assessment Form

Parent Information (check one):

( )Married - Provide both 2015 Notice of Assessment documents issued by CRA

( )Separated or Divorced - Provide the 2015 Notice of Assessment document issued by CRA of the parent with whom you currently live, OR last lived, OR who last supported you.

( )Single/Widowed provide the 2015 Notice of Assessment document issued by CRA* for your parent)

Father’s 2015 income as reported on line 150 of Income Tax Return (provide 2015 Notice of Assessment documents issued by CRA)
Mother’s 2015 income as reported on line 150 of Income Tax Return (provide 2015 Notice of Assessment documents issued by CRA )
# of dependent children registered in full-time post-secondary studies for the 2016 -2017 year (including yourself)
Enter your pre-study income (gross earnings for the 16 week period prior to your study period)
Spouse’s (if applicable) 2015 income as reported on line 150 of Income Tax Return: you must submit a copy of your spouse’s Notice of Assessment document issued by Canada Revenue Agency.

Financial Resources:

Bank balance at beginning of the academic year (for fall/winter students this is Sept. 1) before paying tuition/ expenses
Parent’s OR Spouse’s contribution toward this academic year
Academic Awards/Bursaries/Scholarships ( known)
Employment income during study period.
Total Out of Province Loan Assistance (you must attach documentation providing proof of this funding)
Student bank loan/Personal Line of Credit (available balance only)
Government Income/ Sponsorship Funding (specify):
Other income– including Investments, e.g. GICs, mutual funds, bonds, RRSP’s, RESP’s etc. (specify):
Any other income you will be receiving that is not listed above.
TOTAL