Entrance Bursary Application – College of the Rockies

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Your Residency Status(Required)

I am a citizen or permanent resident of Canada

You must be a citizen or permanent resident of Canada to be eligible for this bursary.

Secondary School(s) Attended: Grade 11(Required)

Please use full name of school. Eg: Mount Baker Secondary School

Address

City State / Province / Region

Secondary School(s) Attended: Grade 12(Required)

Please use full name of school. Eg: Mount Baker Secondary School

Address

City State / Province / Region

Secondary School Graduation Date (Month and Year):(Required)

Post-Secondary Education Plans

Briefly describe your academic and career goals. Why you chose to attend College of the Rockies?

Community Service/Leadership(Required)

Briefly describe the activities in which you have participated as a volunteer in the community at large. For activities in which you took a leadership role, briefly state why it was important for you to assume the role of leader.

Have you applied for a student loan?(Required)

Yes

No

While in school, do you plan to:(Required)

Live at home with family

Rent, on your own

Own your home

Budget: Information while attending college (current school year only)

Program you are entering at COTR(Required)

Funding (Enter total dollar amount)

Bursaries

Scholarships

Student Loan

Savings or RESP

Sponsorship (EI, Band, etc)

Other Income*

Please explain the source of your other income:

Total Funding

Monthly Income

Income/Wages

/month

Spouse's Income

/month

Family Allowance

/month

Child Care Subsidy

/month

Sponsorship (EI, Band)

/month

Other monthly income*

/month

*Other monthly income details:

Total Monthly Income during your Program

monthly income * number of months of program

One Time Program Cost Expenses (current academic year) while at College of the Rockies

Tuition Fees

Books/Supplies

One-time Exceptional Expenses

Please explain your one-time exceptional expenses:

Total Program Costs

Rent or mortgage (including taxes)

/month

Food and basic living necessities

/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

Please explain any other monthly expenses:

Total Monthly Expenses for the duration of your program

Total Resources (Funding + Income)

Total Expenses

program costs + monthly expenses * number of months of program

Total Need

(total expenses) minus (total resources)

Signature(Required)

Date(Required)

Phone

This field is for validation purposes and should be left unchanged.