EDUCATION SERVICES REQUEST

EDUCATION SERVICES REQUEST

AAMJIWNAANG EDUCATION DEPARTMENT
POLICY:

Purpose of the funds: The Education Department has developed a new funding policy to financially assist students who require educational support to further succeed in their education. Such as, but not limited to: tutoring, bus passes, registration & course fees, end of year school field trips etc., based on the availability of funds.

What we cannot fund:

1. Individual payments, without receipts. (i.e. distribution of per capita funding)

2. Individual or Group applicants for profit

Eligible applicants:

1. Registered Band Members of Aamjiwnaang First Nation

The Education Department will take into consideration all requests made by the individual to the Aamjiwnaang First Nation Education Department. The maximum funding is $2,500.00 (CAN) per/fiscal

PROCESS:

1. Application must be fully completed and signed.

2. Provide supporting documents if any, such as proof of registration for course fees, tutoring, bus passes.

3.All original receipts must be submitted for reimbursement and auditing purposes and HST rebate to the Finance Department. Receipts must be within the current fiscal year (April 1 to March 31); past fiscal years will not be approved.

4. Direct billing requests must be to an accredited agency (no private services will be approved Upon approval, payments will be set up and made directly to the agency/organization/service provider listed on your application.

5. Application will be reviewed and approved by the Education Department.

6. If the application does not meet the requirements, the applicant will be notified by the Education Department.

7. If your application meets the requirements, the applicant will be notified by the Education Department with next steps.
AAMJIWNAANG EDUCATION DEPARTMENT 976 Tashmoo Avenue Sarnia, ON N7T 7H5
Student Full Legal Name*
Student Band Number*
Parent Guardian Full Legal Name 1*
Please complete if under the age of 18.
Parent Guardian 1 Band Number*
Please complete if under the age of 18.
Parent Guardian Full Legal Name 2
Please complete if under the age of 18.
Parent Guardian 2 Band Number
Please complete if under the age of 18.
Address:*
Number, Street Name, City, Province/State, Postal Code/ Zip Code
Contact Number*
(555) 555-5555
Contact Email*
example@example.com
Do you have Direct Deposit set up with our Finance Department:*

Yes, I do.No, I do not.
If so please, list name on Direct Deposit
If not, please provide a direct deposit form to be utilized.

Cancelof
Student Education Information:
Academic Year*
Current Grade of Student*
Name & Address of School/Institution Attending:*
Does this student have an IEP?*

YesNo
Student ID Number
Education Service Request

Please attach all supporting documentation for this request.
Type of Request:*
Registration fees, tutoring, bus passes etc.
Cost of request for reimbursement:*
Please upload a copy of your receipt. *

Originals must be provided upon request in a timely manner.
Cancelof
Duration of services:
If applicable.
Name & Address of Agency/Store/Organization/Services:*
Your Contributions:*
DECLARATION:
- It is agreed to provide the necessary documents as required and requested
- If funding is approved, it is agreed that any/all Reporting Requirements will be followed through in a timely manner. It is understood that failure to meet the Reporting Requirements will affect any future requests.
- It is confirmed that the information contained in this application and the accompanying documents is true, accurate and complete.
Applicant Name:*
Applicant Signature*

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Date*

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Created: 09/29/2024 Updated: 01/23/2025

Please allow for two week processing period.
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EDUCATION SERVICES REQUEST

Student Education Information:

Education Service Request