Grant Form – Charity Foundation

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STUDENT GRANT FORM

STUDENT INFORMATION

Last Name

Middle Name

First Name

Maiden Name

Date Of Birth

Also Known As

Complete Address

Mobile #

Gender

Male Female

Sin

Email Address

Marital Status

Married Un-Married

Status

PR Canadian Protected Person

Total Income (Line150)

Expected Reduced Yearly Income

Highest Educational Attainment

Date Completed High School (MM/YR)

Current Job

Start Date

Company Name

Do you have My Alberta Digital ID (MADI) Account?

Yes No

Have you lived in Alberta all your life?

Yes No

If No, Is Alberta the last province you have lived in for 12 consecutive months without being a full-time student?

Yes No

Have you received Canada Student Loan Funding from a province other than Alberta?

Yes No

DEPENDENT INFORMATION

Last Name

First Name

Relationship

Date of Birth

Monthly Childcare Cost

SPOUSE/PARTNER PERSONAL INFORMATION

Last Name

First Name

Middle Name

Date of Birth

SIN

Mobile #

Total Income (Line 150)

Expected Reduced Yearly Income

Has your Spouse/Partner lived in Alberta all their life?

Yes No

If No, Is Alberta the last province your Spouse/Partner has lived for 12 consecutive months without being a full-time student?

Yes No

Will Spouse be a Full Time Student at any time during your study period?

Start Date of Study

End Date of Study

EMERGENCY CONTACT (If Single/Divorced/Separated)

Full Name

Complete Address

Mobile #

Relationship

Final Remarks

UPLOAD FILES

Government issued ID

NOA (Notice of Assessment)

DIPLOMA

ASSISTED BY WHICH AGENT?

EX. PASSPORT

DRIVERS LICENSE

IDENTIFICATION CARD. FRONT & BACK

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