OPASKWAYAK EDUCATIONAL AUTHORITY INC. P. O. Box 10370, Opaskwayak, MB R0B 2J0 Post-Secondary Program: (204) 627-7480 Toll Free: 1-800-661-7981 Fax: (204) 623-2870 Vocational Program: (204)627-7181 Fax: (204)623-5316 Email: oea@mts.net Web Page: www.opased.com Application for Post-Secondary or Vocational Programs Date Received: Application Deadlines: May 1 st for September Intake for Post-Secondary June 30 th for September Intake for Vocational November 30 th for January Intake for Post-Secondary Please check one: Post-Secondary Vocational Applications MUST INCLUDE the following: Post-Secondary OR Vocational ( ) Copy of latest transcript; ( ) Copy of latest transcript; ( ) Copy of treaty card; ( ) Copy of treaty card; ( ) Copy of Social Insurance Number; ( ) Copy of Social Insurance Number; ( ) Acceptance Letter from Post-Secondary Institution; ( ) Verification of Dependents, Including Spouse (if applicable) ( ) Acceptance Letter from Vocational Institution; ( ) Verification of Dependents, Including Spouse (if applicable); ( ) Two (2) Typed References (Academic, Character); ( ) Two (2) Typed References (Academic, Character); ( ) Child Abuse Registry/Criminal Records Checks (if applicable); ( ) Child Abuse Registry/Criminal Records Checks (if applicable) ( ) Banking Information ( ) Course Costs including special equipment and textbooks; ( ) Banking Information Applicant s Name:
SECTION 1. PERSONAL Full Name: Treaty#: (Surname) (First Name) (Middle Initial) (10-digit) Birth Date (y,m,d): Social Insurance Number: Next of Kin and Telephone #: Permanent Address (including postal code): Re-Location Address (including postal code): Telephone/Cellular # s: E-Mail: Social Media: SECTION 2. FAMILY INFORMATION Single: Married: Common-law: Name of Spouse: Length of Relationship: Birth Date (y/m/d): Spouse Income (monthly): (social assistance, benefits, employment, etc.) Dependent(s) 17 & Under Residing with Student Birth Date (y,m,d)
SECTION 3. ACADEMIC BACKGROUND Secondary Education: High School or Mature Diploma Name of School Grade Completed Year Post-Secondary/Vocational Education: Post-Secondary/Vocational Institution Attended Program of Studies Completion of Program Year Yes No Yes No SECTION 4. POST-SECONDARY PROGRAM / VOCATIONAL PROGRAM APPLYING FOR Post-Secondary or Vocational Institution Attending Location (town/city) Name of Program (Certificate, Diploma, Degree) Student Number Full-time or Part-time Person with Disability Length of Program Transition Year Yes No Yes No Expected Date of Graduation
SECTION 5. CAREER GOALS (Must be hand written and must include information that would help in assessing suitability and readiness for post-secondary or vocational studies i.e. how you became interested in your chosen career and why you should be chosen for sponsorship)
SECTION 6. DECLARATION I hereby agree to the following conditions for sponsorship for the duration of my program of studies: To attend classes on regular basis; To be punctual for each class; To consult with my Counsellor on any challenges I may be experiencing (academically, emotionally, financially, etc.) To adhere to post-secondary/vocational institution rules and regulations (including deadlines, withdrawal forms, etc.) To meet the academic requirements for each term for continuation of sponsorship of my program of study; To provide marks or transcripts when requested; To contact my Counsellor on a monthly basis (telephone, email, Facebook, etc.) To read and become familiar with the rules and regulations of the Post-Secondary Handbook; To inform my Counsellor if there are any changes to my demographics such as residence, dependents, banking information, telephone number, etc. To speak with my parents/guardians regarding my post-secondary education. (strike out and initial if not applicable) As a sponsored student, I will conduct myself in a professional manner, including acceptable and positive social media (Facebook, Twitter, etc.); To authorize my Counsellor to obtain, release and exchange information with my postsecondary institution for the duration of my program of studies; I declare that the information provided by me on the application form is complete and correct which substantiates my entitlement for sponsorship; I have read and agree to the conditions for this financial assistance. Student Signature: Date: Witness Signature: Date: