Bursaries/Scholarships Application – College of the Rockies

Name*
First Last
Student Number*
Use full format e.g. c0011111
Social Insurance Number*
Email*
Phone*
Date of Birth*
Date Format: DD slash MM slash YYYY
Gender*
- Male
- Female
- Other
Do you have an approved documented disability?*
- Yes
- No

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Address*
Street Address Address Line 2 City Province Postal Code (e.g. A1A 1A1)
Marital Status*
Number of Dependents
Please enter a number from 1 to 99.
Ages of Dependents
Columbia Basin Resident
This option qualifies you for additional bursaries and scholarships.
- I am a Columbia Basin Resident
Columbia Basin Trust Bursary Amount ($CAD)
If you are eligible to receive a Columbia Basin Trust bursary, how much would you request to support your educational needs this year?
Who is a Columbia Basin Resident?
A Columbia Basin Resident must have a minimum of three years of continuous residency in CBT's mandate area immediately prior to their application. Students who might have resided temporarily outside CBT's mandate area for education but retained their permanent address in the Basin will be deemed as having lived in the Basin. You can view a map of the region to see if you qualify.
Aboriginal Ancestry
- Inuit
- Métis
- First Nations
Affiliations (Check all that Apply)
CORFA (College of the Rockies Faculty Association)
Is your parent/grandparent/sibling/spouse a member of: CORFA?
- Yes
What is the name of the CORFA member?*
What is the CORFA member's relationship to you? e.g. parent, grand-parent*
How will this award benefit you in your future goals?*
CUPE (Canadian Union of Public Employees) - College of the Rockies Local 2773
Is your parent/grandparent/sibling/spouse a member of CUPE?
- Yes
What is the name of the CUPE member?*
What is the CUPE member's relationship to you? e.g. parent, grand-parent*
College CUPE Member
Are you a member of CUPE local 2773?
- Yes
CP Rail
Are you a child of a CP Rail employee?
- Yes
Are you a member at a Credit Union or Kootenay Savings?
- Yes
Branch
Which Credit Union or Kootenay Savings branch are you a member of?

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Last High School Attended*
Please do not use abbreviations.
Describe your Educational Goals*
Will you be returning to College of the Rockies next year?*
- Yes
- No
Institution or Organization
State which institution or organization you will be enrolled with and the program of study:
Student, Community or Volunteer Activities
Briefly describe your involvement in student, community or volunteer activities (if any).
Career Goals*
Describe your career goals (if known):
Please check the list of Bursaries and Scholarhsips for Current Students to view which awards require an essay.
Essay Submission
If required, please submit your essay here. (500 word maximum):

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Program Enrolled in*
Start Date*
When did you start your program for the current: 2019/2020 term?
Date Format: MM slash DD slash YYYY

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Student Loan*
Have you applied for a student loan through your province for the college academic year?
- Yes
- No
In which province did you apply for your student loan?*
If you did not apply for a student loan, why not?*
Other Types of Financial Assistance
List all other types of financial assistance you have received. This includes such things as: Bank Loans/Line of Credit, Scholarships, Bursaries, HRDC, Band Funding, etc. (include name of organization and award / Amount received).
Has COVID-19 affected your finances for school?
- Yes
How have your finances been affected?

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Do you Own, Lease or Drive a Motor Vehicle?*
- Yes
- No
If Yes, Please Provide the Following Information:
Date Purchased*
Date Format: MM slash DD slash YYYY
Year of Vehicle*
Model*
Current Value*
Amount Owing*
Do You or Your Spouse own Assets?*
A home, real estate, stocks, bonds, RRSP's, etc.
- Yes
- No
Please Specify Types, Current Value and Purchase Date*

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If you are working, including COTR Student Opportunities positions, please complete the following:
Position
Employer Name
Average Hours per Week Worked
Average Weekly Take Home Pay

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One Time Income Sources
Savings at Beginning of Educational Period
Student Loan/Grant
Scholarship/Bursaries
Including Passport to Education
Sponsorships
EI/Band Funding, WCB, School District, etc.

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One Time Expenses (current academic year) while at COTR
Tuition Fees
Books/Supplies
One-time Exceptional Expenses

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Monthly Income/Resources (while attending COTR)
If you report '0' resources, you will be eligible for a bursary.
Part-time Income Including Student Positions
/month
Spouses Income After Deductions
/month
Parent / Guardian Contribution
/month
Family Allowance / BC Benefits / Child Tax Benefits
/month
Daycare Subsidy
/month
Income Assistance
/month
Child Support
/month
Sponsorship (EI, Band, WCB, etc)
/month
Income from Assets
/month
Other Monthly Income
/month
Other Monthly Income Details

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Monthly Expenses (while attending COTR)
Rent or mortgage (including taxes)
/month
Food
/month
Utilities (hydro, gas, phone, cable)
/month
Insurance (vehicle, life, house)
/month
Loan payments (vehicle, credit cards, etc.)
/month
Transportation
/month
Child Care
/month
Miscellaneous (entertainment, haircuts, etc.)
/month
Medical / Dental (prescriptions, glasses, etc.)
/month
Other Monthly Expenses
/month
Other Monthly Expenses Details
Additional Comments
Is there anything else you would like the committee to know about your financial situation?

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Budget Information - Review
Total One Time Income
Total Monthly Income
monthly income * number of months of program
Total Income
Total One Time Expenses
Total Monthly Expenses
monthly expenses * number of months of program
Total Expenses
Total Need
(total expenses) minus (total income)

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Step 1 of 13 - Personal Information - Section 1

One Time Income Sources

One Time Expenses (current academic year) while at COTR

Monthly Income/Resources (while attending COTR)

Monthly Expenses (while attending COTR)

Budget Information - Review