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Emergency Funding

Emergency Funding Application

This application should be submitted by current University of Regina students who find themselves in a financial crisis.

Student ID * First Name * Last Name * Current Mailing Address (including unit number) * City * Province * Postal Code * Email Address * Phone Number *

Have you ever applied for emergency funding at the U of R in the past? * Yes No

How much funding do you need? * What is this funding for? * Explain in as much detail as possible what emergency has occurred in your life, and outline the circumstances that have led to this crisis. Your application must explain what has changed in your financial plans to pay for your living expenses. This funding cannot be requested to pay your tuition, as that is an expected cost for all students. (minimum 250 words): * Please indicate what impact this funding will have on your education: *

Financial Disclosure

You are required to disclose the total income and expense amounts you have or will earn/incur for the current term. This section is very important and must be filled out in full in order to assess your eligibility for emergency funding. If you know how much you receive/spend monthly on an item, then multiply that number by 4 for the whole term.

INCOME (FOR THIS TERM)

Canada Student Financial Assistance Scholarship/Award/Bursary Third-Party Assistance Employment Spouse/Partner Income Child Tax Benefit Other (Enter Amount and Explanation) Total Income

EXPENSES (FOR THIS TERM)

Tuition * Textbooks * Rent * Utilities * Food * Bus/Car/Gas Childcare Other (Enter Amount and Explanation) Total Expenses *

I declare that the information I have provided in this application is true, complete and accurate. I understand that all information I have provided in connection with this application is subject to verification and audit by the University of Regina. I understand that I may only receive a bursary one time in my academic career at the U of R. * Yes, I declare.

I understand that personal information in connection with this application is collected under the authority of The University of Regina Act and is needed for administrative and statistical purposes. If you have any questions about the collection, use and disclosure of your personal information by the University of Regina, please contact the Associate Director, Enrolment Services, Room 108 Administration-Humanities Building, University of Regina, Regina, SK, S4S 0A2, 306.585.4591. * Yes, I understand.

I understand that I am required to email my three last months of bank statements to safa@uregina.ca as supporting documentation of my finances in order for this application to be processed. * Yes, I understand.

Privacy Statement

The University of Regina collects and creates information about students (personal information) under the authority of the University of Regina Act and in accordance with The Local Authority Freedom of Information and Protection of Privacy Act and the Personal Information Protection and Electronic Documents Act, for purposes of admission, registration, and other decisions on students' academic status, and the administration of the University and its programs and services. Some of this information may be disclosed to the relevant students' society and alumni association, and will be reported as required by federal or provincial authority. Information regarding the admission of current high school students may be shared with the student's current high school as needed. Any misrepresentation may be shared with other post-secondary institutions. By enrolling in courses at the University of Regina, students consent to the collection, use, and disclosure of personal information as described in the Declaration and Consent section. If you have any questions about the collection, use and disclosure of your personal information by the University of Regina, please contact: Student Awards and Financial Aid, Room 108, Administration-Humanities Building, University of Regina, Regina, SK, S4S 0A2, 306.585.5345