bursaries and scholarship awards · ¨ current resume – ogtt applicants only. i am aware that if...

“Indspire’s goal is to help students realize their dreams and aspirations to build brighter futures.”

Application Form Mail completed forms to:

Indspire Post Secondary Education Department Suite 100 - 50 Generations Drive, Ohsweken, Ontario N0A 1M0

Fax and email copies are not accepted

Building Brighter Futures: Bursaries and Scholarship Awards Application Form 1 of 12

Bursaries and Scholarship Awards

Background:

Building Brighter Futures: Bursaries And Scholarship Awards

The Building Brighter Futures: Bursaries and Scholarship Awards category is categorized into seven areas of study. Types

1st deadline are not eligible to reapply to the November 1st deadline. Applicants may only apply to one program, with

will also be considered for the PSE and Health Careers programs if their program is eligible and they did not receive the OFIFC award.

Please check the Building Brighter Futures: Bursaries and Scholarship Awards program to which you wish to apply. In the event that the deadline date falls on a weekend, the deadline date will be the Friday before the due date.

Check One

Name Eligible Fields of Study Type(s) of Program Deadline

FA Fine Arts1. Graduate and

Undergraduate2. Lessons3. Internship

Post secondary studies, personal develop-ment, training with a professional or at a

such as visual, performing, media, theatre,

Fine Arts degree programs, advanced training, and professional development. Internships are also eligible for funding assistance provided the

internship.

May 1st

PSE Post Secondary Business, commerce, science, law,

technical studies.

June 1stNovember 1st

HC Health Careers Studies in health care careers such as; -

apy, pharmacy, clinical psychology, labora-tory research and veterinarian medicine.

professional and graduate degree programs of at least two academic years at an accredited

-side of Canada is considered only at the graduate level.

June 1stNovember 1st

LSAP Legal Studies for Aboriginal People Pre-Law Bursary

The LSAP bursary is available to Non Status

who are enrolled in a pre law program at an accredited Canadian post secondary

Pre-law summer programs only. A bursary award May 15th

OGTT Oil, Gas, Trades and Technology General For students study-ing in Alberta,

Ontario.

Studying in trades such as but not limited

Mechanic, Heavy Equipment Operator, Heavy Equipment Technician, Instrument Technician, Insulator, Machinist, Mechanic,

Process Operator, Valve Technician, Welder and Ironworker

--

April 30th (General)November 30th (General)Open All year

OFIFCof Indian Friendship Centers

Post secondary studies or training and development, can be less than 2 years.

Mature Aboriginal women with dependent chil-

in the province of Ontario. One $10,000.00 award or two $5,000.00 awards

May 1st

FAAY Advancement of Aboriginal Youth - Canadian Council for Aboriginal Business

Open to students in Grade 9 up to gradu-ate post secondary level who are pursuing or plan to pursue studies in business.

Applicants may apply to the FAAY and Indspire’s June 1st

2 of 12

Full-time certificate or diploma programs, undergraduate and graduate degree programs of at least one academic year at an accredited post secondary education institution. Study outside of Canada is considered only at the graduate level.

Section 2 – Declaration and Consent:

Section 1 – Personal and Contact Information Full Name(Use legal, given name, no aliases or stage names.)

First Name Second Name or Initial Last Name

¨ Male ¨ Female

Mailing Address Street or Box Number City/Town Province Postal Code

Telephone Home Phone: Cell:

Personal Email Address: School Email Address:

Date of Birth: Day/Month/Year

Current Age: Social Insurance Number:

I am aware that the mandatory documents listed below are required to be assessed by Jury, and have included the following with my application package: ¨ One current Indspire Building Brighter Futures: Bursaries and Scholarship Awards Application form fully completed and signed. ¨ Proof of First Nation (status or non-status), Inuit or Métis status. ¨ Letter of Introduction (maximum 1,500 words, Section 7 of this application form ) ¨ Marks (official or unofficial) from your most recent academic program. Your recent marks include your grades from the last semester or term of your

academic program OR from a program you completed before starting the current program in which you are enrolled. Applications submitted without grades or marks will not be assessed.

¨ Work Sample – for Fine Arts applicants only. See Section 8, page 8 of the application form. ¨ Applicant Assessment Form – Fine Art LESSONS applicants only. See Section 9, page 9 of the application form. ¨ Employer Recommendation Form – OGTT Apprenticeship applicants only. See Section 10, pages 10 and 11 of the application form. ¨ Letter of Recommendation Form – OGTT General applicants only. See Section 11, page 12 of the application form. ¨ Current Resume – OGTT applicants only.

I am aware that if my application is successful and the Jury allocates an award, the award is conditional upon Indspire receiving the following documents by JUNE 30th, 2014 otherwise my award will be forfeited.

¨ Original Official Transcript - stamped and signed by the Registrar’s Office from my most recent academic program. Faxed, scanned or photocopies are not acceptable.

¨ Proof of Full-time Enrollment – for the timeframe that coincides with the number of months I am requesting funding for. ¨ Recent, clear color electronic photograph – of head and shoulders in jpg., eps, tiff format minimum 300 dpi, this can be emailed to education@

indspire.ca ¨ Verification of Current Tuition and Fees – from program calendar, brochure, web page, web account, or the Registrar’s office. ¨ Letter from Band/Post Secondary Education Office or Support Organization regarding funding for the application year. This does not apply to Métis

students. ¨ Indspire Financial Report Form – if you have received an award from the previous year and have not yet forwarded it to Indspire.

My signature below confirms that:

ü I am/will be enrolled in full time studies for the number of months indicated on the budget section of my application for the current academic year. ü I have read and fully understand the guidelines that govern the application and Jury process, and I have provided answer to all questions which apply

to me. ü I certify that all information contained on this form is true and correct. I understand that any false statements intentionally given on this application,

by email or telephone will disqualify my application and will affect my ability to access future funding. ü I hereby give my consent to Indspire to release my contact information to Indspire’s sponsor(s), including my name, telephone number, email, or mail-

ing address, so that they may contact me personally. ü I hereby give my consent to Indspire to use, publish my name, photo and relevant information on Indspire’s website, in Indspire’s brochures for pro-

motion, marketing, advertising or in sponsor communications. ü I acknowledge that if my application package does not include all the required documents my application will be deemed ineligible. ü I recognize that it is my responsibility to ensure that all supporting documents are post dated and/or received by the Indspire office by the deadline.

______________________________________________ ______________________________________________ Applicant’s Signature Date


Section 3 – Indigenous AffiliationIndigenous Ancestry Name of Band, Community

or OrganizationNation i.e. Cree, Ojibway, Dene, etc. Province or Territory

¨ Status First Nation

¨Non Status First Nation

¨Métis

¨ Inuit

Section 4 - EducationName of Post Secondary Institution you are/will be attending. Confirmation of Enrollment

¨ Yes ¨ NoFor Fine Arts applicants, name of Company of Lesson Provider:

For FAAY applicants, (currently in Grade 9-12) name and place of high school:

Level of Study:

¨ Certificate ¨ Diploma ¨ Undergraduate Degree ¨ Graduate Degree ¨ Professional Designation ¨ Fine Arts Lessons ¨ Secondary ¨ (high school) ¨ Other _______________________

Name of your upcoming program of study:

For Fine Arts Lessons applicants, name of area of lessons:(i.e. Vocal, Dance, etc

For Fine Arts Lessons applicants, how many years or months of lessons have you completed?

For FAAY applicants, Current Grade Level (please check)

¨ 9 ¨ 10 ¨ 11 ¨ 12

Expected date of completion of program

Current Year of Study (please check)

¨ 1 ¨ 2 ¨ 3 ¨ 4 ¨ 5 ¨ 6 Other: _________

Start Date for this academic term (mm/yy)

Finish date for this academic term (mm/yy)

Length of program (in years)

¨ 1 ¨ 2 ¨ 3 ¨ 4 ¨ 5 ¨ 6 Other: _________

What job/career/occupation do you hope to have when you graduate?

Is this your final year in this program?

¨ Yes ¨ No

From (mm/yy)

To(mm/yy)

Name of InstitutionFor Fine Arts Applicants, name of lesson provider(s)

Name of Program (certificate, degree, diploma or apprenticeship granted)


Part 5 – Determining Financial Need

Indspire encourages all students to make a personal financial contribution to the costs of their education.

Residency while in school: ¨ On my own ¨ With Roommate(s) ¨ With Parent(s) ¨ With Spouse or Common Law

Partner ¨ Student Residence ¨ Subsidized Housing ¨ With child(ren) ¨ Other – Please specify:

Current Marital Status: ¨ Single ¨ Married ¨ Common Law ¨ Separated ¨ Divorced ¨ Widow/Widower

Number and Age of Dependants under age of 18:

¨ 0 ¨ 1 ¨ 2 ¨ 3 ¨ 4 ¨ Other ¨ Ages of dependants:

Current Employment: ¨ Full Time ¨ Part Time ¨ Occasionally ¨ Not Working

While in school, I will work: ¨ Yes ¨ No ¨ Not sure

Student Funding: *Students who are or may be receiving funding are still eligible to apply.

Have you been approved for sponsorship by a First Nation, Inuit or Métis organization?

¨ Yes ¨ No ¨ Pending

If yes, what does your funding include: ¨ Living Allowance ¨ Tuition ¨ Partial Tuition ¨ Books and Supplies ¨ Transportation ¨ Rental Subsidy ¨ Day Care Subsidy

Are there any payments made directly to your institution, if so what are they?

Name of Sponsoring Organization Do not use Acronyms:

Student Loan(s):*Not Applicable to FAAY applicants in high school or Fine Arts Lessons Applicants.

Prior Student Loan(s)¨ Yes ¨ No

Total amount of outstanding student loan(s)

Do you intend to apply for a student loan for current school year?¨ Yes ¨ No

If yes, for what amount? If yes, has your application been approved? ¨ Yes ¨ No ¨ Pending

Line of Credit:*Not Applicable to FAAY applicants in high school or Fine Arts Lessons Applicants.

Do you have a student line of credit?¨ Yes ¨ No

What is the total amount of line of credit?

What amount is currently available to use?

What are your monthly payments?

Other Bursaries and Scholarships: Have you applied or do you plan to apply for other bursaries or scholarships to the current school year?

¨ No ¨ Yes, see following list

Bursary/Scholarship: Amount: Confirmed, Pending or Unsuccessful:


Section 6 – Budget *Not Applicable to high school students applying under the FAAY program.

My School Length (in months) ¨ 8 months ¨ 10 months ¨ 12 months Other:

Part A - Income:List all sources of income for the months in school

AMOUNTPer Month

X # of Months in School

TOTAL

Total confirmed bursaries and scholarships X X

Total hst/gst rebates for current academic year

X X

Total sponsorship for tuition¨ confirmed ¨ confirmation pending¨ funding unavailable

X X

Total sponsorship for books and supplies¨ confirmed ¨ confirmation pending¨ funding unavailable

X X

Total amount for incentives or other monetary gifts

X X

Total amount A X X

Monthly sponsorship funding ¨ confirmed ¨ confirmation pending¨ funding unavailable

Monthly training allowance - other than band, sponsor or organizational funding i.e. Employment and training

Monthly income from spouse or partner (after tax)

Monthly income from savings or employ-ment (after tax)

Monthly child support received for dependent child(ren)

Monthly pension income (i.e. Orphan benefits, CPP)

Monthly contribution from parents (if applicant is under 18 years of age)

Monthly child tax benefit/family allowance

Monthly social assistance

Monthly other income – please identify_______________________* student loans are not considered income*

Total Income = total monthly income x number of months in school

Total income = total amount A + total monthly sources of income

Part B - Expenses:List all expenses for the months in school Fine Arts lessons applicants include costs of lessons.

AMOUNTPer Month

X # of Months in School

TOTAL

Total tuition/training for the year X X

Total cost of books and supplies X X

Total cost of student fees or competition fees – fine art applicants only

X X

Total cost of professional attire i.e. Uniforms, costumes or professional clothing required as part of training or practicum.

X X

Total cost of transportation for home community visits (if you moved from home for post secondary)

X X

Total amount B X X

Monthly mortgage, rent, or residence fees

Monthly food

Monthly toiletries – i.e. Laundry, cleaning and personal supplies

¨ Heat ¨ Electricity¨ Water ̈ Telephone¨ Internet ¨ Cable

Monthly school transportation – i.e. Bus pass, gas, parking fees

Monthly childcare – i.e. Day care or sitter

Monthly entertainment or recreation –movies, gym etc.

Monthly clothing

Monthly insurance ¨ Car ¨ life¨ Home and contents

Monthly vehicle or lease payments

Monthly credit card payments¨ ___________________¨ ___________________¨ ___________________

Monthly other expenses – please identify

Total Expenses = total monthly expenses x number of months in school

Total expenses = total amount B + total monthly expenses

TOTAL INCOME (Part A) – TOTAL EXPENSES (Part B) = FINANCIAL NEED$ - $ = $ NOTE – Expenses must exceed income in order to be assessed.

TOTAL FINANCIAL NEED REQUESTED:$


SECTION 7 – Letter of Introduction This is an award for First Nation, Inuit and Métis peoples, therefore, your involvement, engagement and participation in the First Nation, Inuit or Métis community is of utmost importance.

Your letter of introduction (maximum of 1,500 words) must include the following:

1. Where were you born, where did you grow up, who is your family and community?2. What is your knowledge of your Indigenous affiliation?3. Describe how you participate in the Indigenous community; past, present and/or future? Give examples.4. How do you help promote awareness of Indigenous people, culture and traditions? In the community? At your

school? 5. Describe some Indigenous events or celebrations you have attended, participated in or volunteered at.6. What led you to choose your current field of study?7. What are your hopes and dreams for your future career and employment?8. How do you intend to contribute to the Indigenous community when you complete your post secondary studies?9. How would your field of study be of benefit to the Indigenous community and/or people?10. What skills and knowledge have you acquired that has helped you remain committed to your field of study?11. What challenges have you experienced while in school? How did you overcome these challenges?12. What successes have you experienced while in school?13. Are there any special circumstances the Jury should be aware of?

Please note: Your letter of introduction should be typed, double spaced and attached to your completed application.

Language:

1. Do you speak/read/write a First Nation, Inuit or Metis language

¨ Yes If yes, ¨ A little ¨ Moderately ¨ Fluently

¨ Can read or write to some degree ¨ No

2. Do you speak/read/write French language?

¨ Yes If yes, ¨ A little ¨ Moderately ¨ Fluently

¨ Can read or write to some degree ¨ No

Are you an Indigenous Veteran ¨ Yes ¨ No

Are you related to an Indigenous Veteran ¨ Yes ¨ No

Name and relationship to Indigenous Veteran:


Section 8 – Work Sample & Support Material – For Fine Art Applicants Only

Type of Work Sample

o CD or DVD o Manuscript o Media Clippings o Photographs

o Slides o Scripts o Other (please describe)

Note: Do not submit originals. Work samples are not returned. Indspire is not responsible for the loss or damage of materials submitted.

Description of Work Sample

1. Name of Applicant:

2. Role of Applicant in relation to work sample (i.e. author performer, director) :

3. Date Work Sample Created:

4. Work Sample Submitted: o maximum 2 minutes of audio in CD or DVD format; o 4 pages of writing; o 10 slides/photos of art; o CD ROM of design work.

5. For work samples (slides, photographs, manuscript, etc.) place items submitted in viewing order and describe each item in Work Sample.

Title Description

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

If submitting a CD/DVD please ensure it is cued or set to where viewing is to start (maximum 2 minutes) If submitting a manuscript or script, limit to maximum of 4 written pages.


Section 9 - Applicant Assessment Form – Fine Arts Lessons Only

Background

Indspire is a nationally registered charity with a mandate to provide financial support to First Nation, Inuit and Métis individuals who are pursuing education and professional development. An important part of our Jury decision making process is to have an objective assessment of the student’s abilities.

It is mandatory that this form be filled out by a teacher, instructor that the applicant is receiving instruction from.If not completed by the appropriate assessor, the application will be considered incomplete. Once completed by the assessor, original assessment forms must be returned to the applicant to be included with their application.

Identification

Student Last Name:

First Name:

How long have you known the student/applicant? Relationship to the Applicant? Instructor Teacher Other: Please specify _____________________

Rating Abilities of Student/Applicant

Please rate the applicant by assessing his/her abilities in accordance with the areas listed on the chart below

Ability and Skill Areas Outstanding Above Average Average Minimal Unable to Judge

Preparedness ¨ ¨ ¨ ¨ ¨

Attendance ¨ ¨ ¨ ¨ ¨

Positive Attitude ¨ ¨ ¨ ¨ ¨

Willingness to Learn ¨ ¨ ¨ ¨ ¨

Attentiveness ¨ ¨ ¨ ¨ ¨

Motivated ¨ ¨ ¨ ¨ ¨

Potential for Development ¨ ¨ ¨ ¨ ¨

Technical Competence for age & level of class

¨ ¨ ¨ ¨ ¨

Proactive – practices outside of class

¨ ¨ ¨ ¨ ¨

Overall evaluation ¨ ¨ ¨ ¨ ¨

Please fill out the information below.

Name of Assessor (Please Print/Type):

Company Name of Lesson Provider:

Address:

Telephone: ( ) Fax: ( )

E-mail address:

Signature of Assessor Date

If you have any questions feel free to contact Indspire’s Education Department (toll-free) at: 1.855.463.7747

IndspireAttn: Education DepartmentSuite 10050 Generations DriveOhsweken, OntarioN0A 1M0


Section 10 - Employer Recommendation Form For OGTT Apprenticeship Applicants Only – Page 1 of 2

Background

Indspire is a nationally registered charity with a mandate to provide financial support to First Nation, Inuit and Métis individuals who are pursuing education and technical training. An important part of our Jury decision making process is to have an objective assessment of the applicant’s work abilities.

It is mandatory that this form be filled out by an employer/authorized person or union representative. If not, the application will be considered incomplete.

The original signed Employer Recommendation Form may be returned to the applicant to be included with their application or mailed directly to:

IndspireAttention: Education DepartmentSuite 100 - 50 Generations DriveOhsweken, Ontario, N0A 1M0

If you have any questions feel free to contact Indspire’s Education Department (toll-free) at: 1.855.463.7747 x253.

Apprentice Applicant Information

Last Name: First Name:

Apprenticeship ID Number: Date Apprentice Employed with Company:

From: To:

Rating Abilities Of Apprenticeship Applicant


Ability and Skill Areas Outstanding Above Average Average Below Average

1. Attitude toward:

Their trade ¨ ¨ ¨ ¨

Training ¨ ¨ ¨ ¨

Co-workers ¨ ¨ ¨ ¨

Workplace ¨ ¨ ¨ ¨

Interpersonal skills and strengths ¨ ¨ ¨ ¨


Rating Abilities Of Apprenticeship Applicant


2. Work Habits:

Safety¨ ¨ ¨ ¨

Attendance & Punctuality ¨ ¨ ¨ ¨

Willingness to learn new skills ¨ ¨ ¨ ¨

Reliability¨ ¨ ¨ ¨

Respect for the property of others ¨ ¨ ¨ ¨

3. Trade Skills:

Work Performance

Please comment on the applicant’s potential to succeed in the chosen trade in light of his/her work experience.

Please explain why you think the apprentice should receive a bursary/scholarship award.

Employer/Union Authorized Signature

Assessor’s Last Name: Assessor’s First Name:

Company/Union Name & Address:

How do you know the applicant? oEmployer oSupervisor oSupervising Training Person oUnion representative

How long have you known the apprenticeship/trainee?

Telephone: ( ) Fax: ( )

E-mail address:


Ability and Skill Areas Outstanding Above Average Average Below Average


Section 11 - Letter Of Recommendation – For OGTT General Applicants Only Page 1 of 2

Background

Indspire is a nationally registered charity with a mandate to provide financial support to First Nation, Inuit and Métis individuals who are pursuing education and technical training. An important part of our Jury decision making process is to have an objective assessment of the applicant’s work abilities.

It is mandatory that this form be filled out by an employer/authorized person or union representative.If not, the application will be considered incomplete.

The original signed Employer Recommendation Form may be returned to the applicant to be included with their application or mailed directly to:

Indspire: Attention: Education Department Suite 100, 50 Generations DriveOhsweken, Ontario, N0A 1M0

If you have any questions feel free to contact Indspire’s Education Department (toll-free) at: 1.855.463.7747 x253.

Name of Applicant:

Relationship to the applicant: o Elder o Teacher o Principal o Community Leader o Employer

1. How do you know the applicant? 2. Length of time you’ve known the applicant? 3. Why would you recommend the applicant for this bursary/scholarship award? 4. Why do you think the applicant will do well in the field of study? 5. Additional Comments. Name of Assessor (Please Print/Type): Institution: Address: Position and Department: Address: Telephone: ( ) Fax: ( ) E-mail address:



bursaries and scholarship awards · ¨ current resume – ogtt applicants only. i am aware that if...

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