FINANCIAL AID PROGRAMMES

FINANCIAL AID PROGRAMMES
I First Name * Last Name * do solemnly and sincerely declare as follows:
Please choose which financial aid support you are interested in applying for:*

Adopt-A-StudentHardship Grant FundThe Freedom Hall Network Group: Dr. Keith Archibald Benevolent FundDepartment of Clinical Surgical Sciences (DCSS) Benevolent FundWe Believe Foundation Grant
SECTION A

Personal Information
Full Name*

PrefixFirst NameMiddle NameLast Name
Student ID Number*
Status*

Full-TimePart-Time
Country of Birth*
Nationality*
UWI Email*
firstname.lastname@my.uwi.edu.
Home Address*

Street Line 1

Street Line 2

City/Town/VillageCounty

Postal / Zip CodeCountry
Current/Term Address*

Street Line 1

Street Line 2

City/Town/VillageCounty

Postal / Zip CodeCountry
Mobile Phone*

Area CodePhone Number
I am renting off campus*

YesNONot Applicable
I am currently living on a Hall of Residence at the UWI St. Augustine Campus*

YesNONot Applicable
If yes, please select the Hall of Residence
Faculty*
Programme*
Degree Option*
e.g. B.Sc. International Relations or B.A. Spanish
Level (Year 4 & 5 applies ONLY to the Faculty of Medical Sciences)*
2020/2021
I am a first generation University Student*

YesNo
I am a dependent of a UWI Staff Member*

YesNo
I currently benefit from the GATE programme*

YesNo
If yes, please indicate your GATE funding means test eligibility *
I am a scholarship holder*

YesNoNot Applicable
If yes, please specify
I received Financial Aid from the UWI in the past*

YesNoNot Applicable
If yes, please state the programme (Adopt-A-Student, Hardship Grant, Other) and the academic year
I am employed*

Full-TimePart-TimeNot Applicable
I am registered for Semester Employment *

YesNoNot Applicable

SECTION B

Declaration of Financial Information

Student or Family Expenditure for the year*

	Amount in $TTD per Academic Year
Tuition Fees (after GATE and/or other funding)
Accommodation Fees (Rent/Mortgage)
Utility Bills (Electricity, Water, Internet, Other)
Meals & Personal Care Items
Transportation (to and from UWI)
Books & Supplies
Other Expenses
Other Expenses
Other Expenses
Other Expenses
Other Expenses
Total Expenditure

Student or Family Income/Resources for the Academic year*

	Amount in $TTD per Academic Year
Parent's Income
Student's Income (If employed)
Student Loan Value
Scholarship or Bursary Award Value
Other Income
Other Income
Other Income
Other Income
Other Income
Total Income

SECTION C

RATIONALE FOR FINANCIAL SUPPORT
IMPORTANT: Please provide a detailed account of your reason for applying for Financial Assistance, noting any information that should be considered in your request for financial support. *
I have experienced food insecurity, that is not knowing where my next meal is coming from, or involuntarily eating less than I need, on a regular basis, for a period of time lasting more than a month*

YesNo
If yes, do you have anything to add to your answer?
Please select any of the following statements that you feel apply to you:*

I do not have physical access to nutritious foodI do not have financial access to nutritious foodI do not consume 4-5 servings of fruit and/or vegetables dailyI have experienced hunger for a month or longerNone of these statements apply to me

SECTION D

Identification and Relevant Supporting Documents
Applicants must upload the following:
• A copy of your National ID and Student ID
• Parent’s mortgage payment or most recent rent payment receipt
• Student’s most recent rent payment receipt
• Parent/Guardian’s payslip or job letter/ letter of retrenchment
• Medical documentation (in cases of illness)
A maximum of 5 files are allowed. Maximum file size 10MB. Please note that submissions of these documents does not guarantee approval. *

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SECTION E

IMPORTANT: Banking Information and ACH Banking Information Form for the Disbursement of Approved Financial Aid
I have a Local Bank Account*

YesNo
If yes, please upload a PHOTO or SCREENSHOT of the top of your bank statement or online banking details. It must display the name on the account, bank name and branch, bank account number, and the type of bank account ONLY

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Update your banking information via The UWI Student Portal by following these steps: *Log in to the Student Portal *Select mySecure Area, then choose Student and Financial Aid *Under Student Bank Information, carefully review the instructions provided *Enter your banking information Have you enter your banking information*

YesNo
Please complete and submit the following ACH Banking Information Form here. *

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ACH Banking Informaton Form
Please sign here (if you have access to a touch screen device)

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FOR OFFICIAL USE ONLY
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FINANCIAL AID PROGRAMMES

SECTION A

SECTION B

SECTION C

SECTION D

SECTION E

ACH Banking Informaton Form