INDIGENOUS STUDENT BURSARY

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The Indigenous Student Bursary is a bursary provided to Indigenous students with financial need who are attending postsecondary programs and/or training programs at either Ontario publicly-assisted colleges and universities or approved Indigenous postsecondary education and training institutions. This bursary was first established in the 2008-09 academic year as part of the Government of Ontario s Indigenous Education Strategy. The value of each bursary ranges from 1,000.00 to 3,500.00. Eligibility: Students can apply if they are: Canadian citizen, permanent resident or a protected person. Resident of Ontario. Officially enrolled and attending classes in a certificate program, part-time undergraduate degree program, full-time undergraduate degree program or graduate studies program in the 2017-2018 academic year. Demonstrate unmet need. CGPA of 1.67 or higher and a clear academic standing. To be eligible for the Indigenous Student Bursary, a student must self-identify as an Indigenous person in Canada. For the purposes of this bursary, an Indigenous person in Canada: o is an Aboriginal person, as recognized in the Constitution Act, 1982 (status card or Métis registry where applicable); or o a person who identifies with a First Nations, Indigenous, Métis, or Inuit cultural and/or ancestral background in Canada. Applying: Completed application must include: Application Form, Budget Form, Personal statement, Notice of Collection of Personal Information Form and FIPPA Statement. Deadline: January 29, 2018 Selection: The selection committee will be made up of members of the Ryerson Aboriginal Student Services. Student Financial Assistance will issue funds to individual students at the direction of the Awards Committee. Application Deadline: January 29, 2018 1

Student Details APPLICATION FORM Name of Student: Student number: Student s current address: City: Contact phone: Postal code: Ryerson e-mail: Student s Program: Select one: [_] Graduate Studies [_] Full-Time Undergraduate Degree [_] Part-Time Undergraduate Degree [_] Certificate Program Please check all boxes to be eligible for the bursary. I am currently a resident of Ontario, and a Canadian Citizen, permanent resident or a protected person. The information I have provided is an accurate representation of my current financial situation. Receipts are available upon request to verify the information listed on the application. I understand if the information on this application is intentionally misrepresented this may be a violation of the Student Code of Non-Academic conduct and I may be asked to repay any bursary funding received. I authorize Student Financial Assistance to review my academic record and current address when required. I hereby certify that the above statements are true and correct to the best of my knowledge. I understand that a false statement may disqualify me for the associated award. Signature: Date: Application Deadline: January 29, 2018 2

Do you wish to self-identify as an indigenous person? For the purposes of this voluntary self-identification, an Indigenous person is: an Aboriginal person, as recognized in the Constitution Act, 1982; or a person who identifies with First Nations (Status/Non-Status), Métis or Inuit cultural, and/or ancestry background in Canada. Yes No I prefer not to answer at this time Do you identify with any of the specific identities provided below? Please check all categories that apply to you: First Nations (Status/Non-Status) Métis Inuit Alternative identity term: (e.g. Kanien kehá:ka, Anishinaabe, Treaty #3, etc.): I prefer not to answer at this time While the above statement of self-identification is voluntary, you must complete the following declaration of status to qualify for this bursary: DECLARATION OF STATUS: I hereby state that I am an Indigenous student and identify as such as per my institution s Indigenous self-identification policy. This assertion means that I identify as a member of the First Peoples of Canada meaning, in general terms, First Nation, Metis, Inuit, Indigenous, or specifically by my home community or my Nation. Signature: Date: Application Deadline: January 29, 2018 3

Student Budget Form This budget captures an individual student s educational expenses during the current academic year (Fall 2017/Winter 2018) most undergraduate programs have an 8 month academic year. If you are enrolled in a program that includes a Spring/Summer Semester as part of its core curriculum please indicate this and calculate your expenses for a 12 month academic year. o my academic program includes a mandatory Spring/Summer term: (name of program) Do not include expenses while on a co-op or work term. Please complete all sections and check the appropriate boxes. Leave the amount blank in the amount field if there is nothing to report. Student budgets submitted with 0 Total Resources or unmet need will not be considered for the bursary. *Note: Guidelines are provided for your reference of expected costs as determined by a standard set by the provincial government, if your actual costs exceed this amount, please include a note with your application for us to take your individual circumstance into consideration. CALCULATE YOUR TOTAL UNMET NEED USING THE TEMPLATES PROVIDED ON THE FOLLOWING PAGES: Total Educational Expenses (A) (Total from Page 5 of your application) Total Resources (B) (Total from Page 6 of your application) TOTAL UNMET NEED: To calculate unmet need: [Total Resources (B)] [Total Expenses (A)] = Unmet Need If your budget does not demonstrate unmet need, you may not qualify for this award or bursary. Please sign below to confirm that the information provided in your student budget forms and above is complete and accurate to the best of your knowledge. Name: Student #: Signature: Date: Application Deadline: January 29, 2018 4

For each item below enter in the total amount which reflects the full academic year for your program, normally 8 months. Do not enter the monthly amount only. Educational Expenses Amount Current year s Tuition fees, no late penalties Current year s Books and related supplies Guideline: we expect that this amount will be approximately 100 per course you are enrolled in, if your program has additional expenses such as material costs for creative programs, supply costs or costs related to your placement please include them here with a note. Accommodation costs (check one box only). (include the portion that you are responsible for only) Guideline: if you are living on your own without dependents we expect that this amount will be a maximum of 1200 per month. Living with dependants (spouse, children, or family members) ( I am a single parent or sole provider for my family) Living away from home on own or sharing. Living in Ryerson residence. (excludes meal plan) Living with family (no dependants). Claim up to 3600 (450 per month). Food (check one box only). Student s portion. Guideline: we expect that this amount will be a maximum of 300-500 per month if you are not also the sole support for dependents. Living away from home, in Ryerson residence, or with dependants. Living with family (no dependants). Utilities, telephone, cell phone, cable & internet costs (check one box only). Student s portion. Guideline: we expect that this amount will be a maximum of (125/month Living away from home, in Ryerson residence, or with dependants. Living with family (no dependants). Personal/Miscellaneous Expenses - includes laundry, personal hygiene, clothing, personal medication, prescription glasses and dental work not covered by private or university medical/dental insurance. Costs for student only Guideline: we expect that this amount will be a maximum of 125/month if you are a student living away from home without dependents. Transportation to and from classes. Student cost only. Within the GTA. Allowable maximum up to 130 per month. Outside GTA. Allowable maximum up to 205 per month (TTC+GO) Travel Expenses for FNTI Students (include transportation costs to/from courses, as well as accommodation costs during classes, if applicable) Within walking distance. Transportation costs 0. Total Educational Expenses (A) (copy this total into the table on Page 4) Application Deadline: January 29, 2018 5

Study Period Resources Amount Savings (include any funds used to pay current year s tuition fees and other school expenses in the summer months) Expected/Earned Employment income, Stipends/ Teaching Assistants, etc. during the academic year Total Band Funding from your First Nation (if Applicable) for Tuition & Books Total Band Funding from your First Nation for Living Allowance (calculate the amount of your living allowance x 8 months) Government student assistance OSAP loans & grants, Out of Province student loans and grants, Enter full year s funding. Specify which one(s) and the amount you are receiving as a loan vs. as a grant for the 2017/2018 Academic Year ONLY * We are asking you to provide information about the amounts you are receiving as both Loans & Grants in order to more accurately assess both financial need for the current academic year, but also to take the burden of repayable loans into account as distinct from non-repayable grant funding. Ryerson Scholarships, Awards, Bursaries or Student Access Guarantee Specify which one(s) Other forms of government assistance (Social Services, Orphan/Disability pensions, allowances, etc.) Specify which one(s) All money/cash/gifts/monthly allowances and/or loans received from parents, spouse/partner or other persons. Include any funds used to pay for tuition fees, books, etc. (grant funding) (loan amount) All other sources of income received Check one: Educational Scholarship Trust Funds/RESP s Other income (income tax rebate, etc.) Other External Scholarships/Awards/Bursaries Total Resources (B) (copy this total into the table on Page 4) Application Deadline: January 29, 2018 6

Personal Statement Applications must also include a short personal statement (max 2 typed & double-spaced pages in length) which addresses the following: - Describes both the successes and challenges experienced while pursuing a postsecondary education. These may include financial, social/cultural, educational, or personal challenges. - Describe your connection to the Indigenous community (whether this be at home, at Ryerson, in your family, work, or in your academic learning). Application Deadline: January 29, 2018 7

NOTICE OF COLLECTION OF PERSONAL INFORMATION The Ministry of Training Colleges and Universities (the Ministry) has provided your college or university with the funding to administer the Indigenous Student Bursary. As a condition of this funding, your college or university is required to make reports to the Ministry of your contact information, the amount of the bursary you receive and the date it was awarded, your study period and information related to your eligibility for the bursary. This personal information will be used by the Ministry to administer and finance the Bursary program. It will also be used to establish the minimum amount of student aid your college or university is required to provide under the Student Access Guarantee (the Guarantee) and to administer and finance the Guarantee. If you apply for OSAP, this personal information will be used to update your OSAP application or award, including your declared income. Administration includes: public reporting on the administration and financing of the Bursary program and the Guarantee; monitoring and auditing your college or university or its authorized agents to ensure that they are administering the Bursary program appropriately; conducting risk management, error management, audit and quality assessment activities; and conducting policy analysis, evaluation and research related to all aspects of student assistance. Financing includes: planning, arranging or providing funding of the Bursary program and the Guarantee. The ministry administers the Bursary program and the Guarantee under the authority of the Ministry of Training Colleges and Universities Act, R.S.O. 1990, c. M. 19, as amended. If you have any questions about the collection or use of this information, contact the Director, Student Financial Assistance Branch, Ministry of Training, Colleges and Universities, P.O. Box 4500, 189 Red River Road, 4 th Floor, Thunder Bay, ON P7B 6G9. NAME: STUDENT #: SIGNATURE: DATE: Application Deadline: January 29, 2018 8

Privacy Consent Form for Student Awards SECTION 1 - NOTICE OF COLLECTION - FREEDOM OF INFORMATION AND PROTECTION OF PRIVACY ACT ( FIPPA ) In accordance with Section 39(2) of FIPPA, the information provided on the award application is collected under the authority of the Ryerson University Act, 1977 and is used by Financial Assistance and Award Administrators at Ryerson University for the purposes of determining and adjudicating your eligibility for financial assistance, including but not limited to financial awards and bursaries. The information collected may also be used on an aggregate basis in order to comply with Ryerson University s statutory reporting obligations. All personal information that is collected will be used, disclosed, stored, and destroyed in accordance with Ryerson University s Procedure for Protecting Restricted Information and Providing Access to Information (see: http://www.ryerson.ca/policies/board/informationprotectionaccessprocedure.html) which is part of the Information Protection and Access Policy (see: http://www.ryerson.ca/policies/board/informationprotectionaccesspolicy.html). If you have questions about the collection, use, and disclosure of this information by Ryerson University please contact Manager, Student Financial Assistance: cscrase@ryerson.ca 416-979-5000 ext 6648. SECTION 2 - CONSENT TO DISCLOSE ACADEMIC RECORD TO FINANCIAL ASSISTANCE In order to assess your eligibility for some forms of financial assistance, we may need to review your academic record. By signing below, you hereby consent to: (i) the collection of information for the purposes set out above in Section 1, and (ii) the disclosure of your academic record by the Registrar to Financial Assistance for the purpose of assessing your eligibility for student financial awards and/or assistance. Please note that if you do not consent to the collection and disclosure, we will not be able to determine your eligibility for some forms of financial assistance. NAME: STUDENT #: (Please Print) (Please Print) SIGNATURE: DATE: Application Deadline: January 29, 2018 9