student housing assistance grant application 2018… housing... · enrolment services 1200-1874...

Enrolment Services 1200-1874 East Mall | Vancouver, BC V6T 1Z1

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Student Housing Assistance Grant Application 2018/2019 - UBC Vancouver

The UBC Student Housing Assistance Grant assists students beginning their first undergraduate degree at UBC’s Vancouver campus, whether they are coming from high school or transferring from another post-secondary institution. The purpose of this program is to financially support academically qualified students who show a keen interest in joining and contributing to the UBC community, but who would not otherwise be able to attend without significant financial assistance. This program will offer twenty (20) one-time grants of up to $10,000 to help cover the cost of the student’s first year housing and/or meal plan.

Criteria

You are a Canadian citizen or permanent resident.

You will be living in UBC Student Housing during the academic year.

You demonstrate financial need.

You will be starting your first undergraduate degree at UBC (both high school and transfer students are eligible).

You are applying to an undergraduate program at UBC’s Vancouver campus.

You have contact information for two (2) references from members of your school or community.

You meet all UBC admissions requirements.

Instructions Please read the instructions carefully before starting your application

Complete this PDF application. Section A and C must be completed by the applicant. Section B must be completed by applicant’s parent(s)/guardian(s). If you have been out of high school for more than 48 months, Section B must be completed by your spouse/common-law partner (if applicable).

Upload and submit the completed PDF application through the online form. You will receive an automated confirmation email after you submit your application.

Do not include extra material, such as certificates, news clippings, or a separately printed résumé.

Late or incomplete applications will not be accepted.

Timeline Completed application (Section A, B and C) must be received by 11:59 PM PST on February 15, 2018.

Student Housing Assistance Grant recipients will be contacted no later than May 15, 2018. Only successful applicants will be contacted.




Student Name (Surname, Given Name) UBC Student Number

Section A: Student

Student Information Surname

Given Name Middle Initial(s) UBC Student Number

Date of Birth (YYYY/MM/DD) Home Phone Cell Phone

Email address:

Citizenship: Canadian or Permanent Resident (Landed Immigrant)

Student Declaration I hereby declare that the information on this application (including the Description of Circumstances) is, to the best of my knowledge, correct and complete. I understand that UBC retains the right to verify information on my application. If I am the recipient of a grant, I understand that by signing this declaration, I authorize The University of British Columbia to: release to Grant Adjudication Committee members the information provided in this application form; prepare a brief biographical profile to be used for grant presentation ceremonies and receptions; release to grant donors my name, contact information (mailing address, telephone number and email address), year and program of study, and other information relevant to the requirements of the grant, for the purpose of maintaining donor relations and informing donors about the outcomes of their gifts. . Date (YYYY/MM/DD) Signature





General Information 1. Have you been outside of high school for more than 48 months?

Yes No

2. Is the government your legal guardian? Yes No 3. Are your parents deceased and you do not have a legal guardian? Yes No 4. Do you intend to apply for a student loan? Yes No

If yes, please indicate the province or territory through which you applied/will apply: If no, please briefly describe how you will be financing your studies:

5. Do you have any children?

Yes (If yes, please fill out the Dependent Information Section) No

6. Please indicate your marital status

Single Married Common-law Divorced Separated Widowed (If Married or Common-law, please fill out the Spouse or Common-law Partner Information Section)

Expenses (September 2018 – April 2019) 7. If you are living away from home, what will your costs for return transportation be (to/from Vancouver)?

Enter 0 if you are living at home. $ 8. What other expenses do you have for the study period (ie. incidental, medical, personal supplies,

recreational activities) NOT including tuition or housing costs $

Please specify:





Income and Savings 9. What was your reported gross income from line 150 of your 2016 Income Tax Return? If you did not file a

return, enter your gross income from all sources both inside and outside Canada: $

10. The net Value of RESPs in your name: $ 11. The net Value of RRSPs in your name: $ 12. The net value of the bonds, term deposits, guaranteed investment certificates, stocks and/or other

investments in your name: $ 13. The net value of any other investment (your share) such as boat, RV, revenue/holdings, recreational

properties, etc. (do not include principle residence or your principle vehicle as an asset): $ Please specify:

14. Resources for the 2018/19 Academic Year: September 2018 – April 2019

Applicants savings for the academic year $

Anticipated earnings from Part Time work during the academic year $

Parental and/or Spousal Contribution $

RESP funding for the academic year $

Social Assistance/EI/Disability Benefits etc $

Scholarships (excluding UBC) $

Bursaries (excluding UBC) $

Sponsored tuition/books $

Aboriginal Band Funding $

Other resources: $




Student Name (Surname, Given Name) UBC Student Number Dependent Information (complete only if answered Yes to Question 5):

15. Number of children Age 0 – 11:

16. Number of children Age 12 – 18 who are not in post-secondary institution:

17. Number of dependent children who are in a post-secondary institution for whom you receive the Canada Child Tax Benefit or for whom you claim a benefit on your Income Tax Return:

18. Childcare costs for the study period: $

19. Amount of childcare subsidy received for the study period: $

20. Amount of child support/alimony paid during the study period: $

Spouse or Common-law Partner Information (complete only if answered Married or Common-law for Question 6):

21. Spouse/Common-Law Partner Name:

22. Occupation:

23. Employer:

24. Reported gross income from line 150 of your spouse or common law partner’s 2016 Income Tax Return. If they did not file a return, enter their gross income from all sources both inside and outside Canada: $

25. During the applicant’s study period, your spouse or common law partner will be (check all that apply):

Working full time Home with dependent children

Living with applicant In full-time study Other

26. If in full time study, will your spouse or common law partner be applying for financial assistance for the upcoming study period Yes No

If no, please briefly describe how they will be financing their studies:

27. Please indicate the net value of any assets (their share) in your spouse or common-law partner’s name (including RESP, RRSP, investments, recreational properties, etc): $

Please specify:





Description of Circumstances

Provide a written statement outlining you and your family’s circumstances that make it necessary for you to apply for a UBC Student Housing Assistance Grant. Explain your interest in joining and contributing to the UBC community and how receiving

this grant will impact your personal situation now and in the future. (maximum 500 words)





Personal Statement Provide a written statement explaining why you wish to live in Residence and why you believe this environment will contribute

to your success as a UBC student. (maximum 500 words)





Section B: Parent/Guardian OR Spouse/Common-Law Partner (If Applicable)

Instructions

Please read the instructions carefully before filling out the Form below:

▪ If you answered No for Question 1 under General Information, your Parent(s)/Guardian(s) must complete this section.

▪ If you answered Yes for Question 1 under General Information, your Spouse/Common-Law partner must complete this section (if applicable).

Income Information:

Parent/Guardian 1 OR Spouse/Common-Law

Parent/Guardian 2

Name

Occupation

Employer

Reported Gross Income from Line 150

of 2016 Income Tax Return $ $

Expected Income for 2017

(January – December) $ $

Employment Insurance (EI) benefits for 2017 $ $

Social Assistance/Welfare and/or

Disability Assistance for 2017 $ $

Worksafe BC/WCB Benefits for 2017 $ $

Child Support for 2017 $ $

Other (including income from investments,

rental properties, pension, family business, etc.).

Please specify each one:

$

$





Asset Information:

Total amount of all money you have saved in your bank accounts $

Total net value of your RRSPs $

Total net value of your term deposits, GICs, stocks, bonds, mutual funds, etc. (Do not include

RRSPs) $

Total net value (your share) of any other assets such as boat, RV, revenue/holdings, recreational

properties, etc. (do not include your principal residence or your principal vehicle as an asset) $

Expenses:

Voluntary parental contribution to the applicant’s post-secondary education during the

period of September 2018 to April 2019 (includes scholarship trust funds) $

Please specify any expenses due to unforeseen circumstances, such as emergency health-

related expenses, emergency home repairs, or an expense that contributed to a financial

shortfall.

$





Family Size Number of children in your family ages 18 and younger not attending a post-secondary institution Ages: Number of children in your family attending a post-secondary institution (including the applicant) Ages:

Parent/Guardian Declaration I hereby declare that the information on this form is, to the best of my knowledge, correct and complete. I understand that UBC retains the right to verify information on this application. I understand that by signing this declaration, I authorize The University of British Columbia to: release to Grant Adjudication Committee members the information provided in this application form and release to grant donors any information relevant to the requirements of the grant, for the purpose of maintaining donor relations and informing donors about the outcomes of their gifts. Date (YYYY/MM/DD) Signature of Parent/Guardian One

Date (YYYY/MM/DD) Signature of Parent/Guardian One

Spouse/Common-Law Partner Declaration (If applicable) I hereby declare that the information on this form is, to the best of my knowledge, correct and complete. I understand that UBC retains the right to verify information on this application. I understand that by signing this declaration, I authorize The University of British Columbia to: release to Grant Adjudication Committee members the information provided in this application form and release to grant donors any information relevant to the requirements of the grant, for the purpose of maintaining donor relations and informing donors about the outcomes of their gifts. Date (YYYY/MM/DD) Signature of Spouse/Common-Law Partner





Section C: Personal Reference Please provide the name and contact information for two references who can elaborate upon your interest in studying at UBC, living in the Residence Community, and may also be able to comment on your financial situation. These references will only be contacted should the Grant Committee require further information or clarification on the information submitted in your application. Appropriate references can include, but are not limited to: coaches, teachers, counsellors, principals, supervisors from work and volunteer positions, family doctors, and community or religious leaders. References should not be family members.

Reference #1

Name:

Relationship:

Phone:

Email:

Reference #2

Name:

Relationship:

Phone:

Email:

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