Dependent Bursary Application Form

• Dependent Bursary Application Form•

Deadlines: August 1st (Summer), December 1st (Fall), April 1st (Winter)

Guidelines (Please read carefully before submitting)

1. The goal of the Dependent Bursary is to provide some additional financial flexibility to members who are in a primary caregiver role and experiencing a financial need to help them achieve their academic and professional goals.

2. The Association defines "dependant" as a family member who requires constant supervision and who cannot physically meet her or his own daily needs. The Association further defines "primary caregiver" as the person who lives in the same residence as the dependant and is physically and financially responsible for ensuring on a daily basis that the defendant's needs are met.

3. The applicant must supply the following to be eligible for this bursary:

A copy of a valid driver's license or passport identification page
Proof of registration at York University, such as a student account or department letter in addition to a valid YU Card
A completed and signed application form

4. The maximum amount that each eligible applicant can receive each academic semester is $300.00. The amount awarded to each applicant is subject to the total number of applicants and the total amount of funding available.

5. Students may apply for the Dependent Bursary each semester. Priority will be given to first-time applicants and to members whose verified household income falls below the Ontario poverty line. Additional applications will be considered on the basis of demonstrated financial need, at the discretion of the adjudicating committee.

6. Only one application shall be eligible per residence.

7. Only registered graduate students are eligible for this fund. The eligible candidates for this bursary must be YUGSA members (both full/part-time registered graduate students). Proof of registration will be required.

Schulich School of Business M.A. students are not eligible for YUGSA Funds and Service as per their Associate Agreement (see YUGSA By-Laws, Appendix A, Article C.viii., p.64)
Osgoode Law Hall students eligible to apply for funds/bursaries include:
- Osgoode Professional Development (OPD) Program Student
- LLM Research Stream Students
- PhD Students

8. Awards are decided by the Funding Committee. Appeals may be submitted in writing to the Funding Committee. Bursary allocations will expire and not be reissued six months after issue.

If you have questions or comments about the eligibility criteria, deadlines, and/or the guidelines and conditions for the funds and bursaries, please contact info@yugsa.ca for more details. Please direct questions regarding funding applications to finance@yugsa.ca.

Funding is issued by electronic funds transfer. If you would like a cheque to be issued please contact finance@yugsa.ca.

Applicant's Information

Full Name*

Student Number*

Department*

(Write department name if not in the list)

Program*

Ph.D.Masters

Year of Study*

Status*

International StudentDomestic Student

Phone Number*

E-Mail Address (York account preferred)*

example@example.com

Dependents Information

How many dependents do you have?*

What is your relation to the dependent(s)? (Separate by commas)

Have you applied for this bursary before?*

YesNo

When did you apply last? (Month, Year)

Attachments can be scanned images or good quality photos of the original documents clearly showing all detail. You may attach multiple files in appropriate file formats.

Please attach: - A copy of applicants valid Driver's Licence or Government Photo Identification *

A copy of the dependents Valid Government ID or Birth certificate *

Proof of Your Registration Status (A screenshot of your student account showing enrollment or a department letter is sufficient. A copy of your York ID is NOT considered a proof of registration) in addition to valid YU Card.*

Please do NOT submit hardcopy prints of this application or supporting documents to our office. Applications requiring signatures will be signed online, A request will be sent to you by e-mail if necessary.

OFFICE USE ONLY (Not to be filled by applicant)

Amount Awarded

Cheque Number

Date of Pickup or Mailing

Date

Please verify that you are human*

Notes

Signature

By clicking the submit button on this application you are confirming that:You are a member in good standing with the York University Graduate Students’ Association (YUGSA).That you aware that any false information given on this application will result in my immediate disqualification from this bursary.You are also aware that the YUGSA reserves the right to request any further documentation related to claims made on this application.