Fillable 2020-21 Ontario Bursary for Students with Disabilities (BSWD) (Collège Boréal)

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2020-21 Ontario Bursary for Students with Disabilities (BSWD) (Collège Boréal)

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1
March 12, 2020
2020-21
Ontario Bursary for Students with Disabilities (BSWD)
Canada Student Grant for Services and Equipment for
Students with Permanent Disabilities (CSG-PDSE)
Each assessment, service or equipment request is considered on an individual basis. Information
provided from your health care provider (doctor or other regulated health care professional) and/or
from your Oce for Students with Disabilities (if applicable) is used to determine what costs will be
funded. You must also meet all the eligibility requirements for this program.
You may be provided funding for all or a portion of the costs of the assessment, services or
equipment requested. Approved amounts are subject to maximum limits so it is possible that not all
your costs are covered.
Purpose
You can get funding to help pay for your disability-related educational services and/or equipment
needed to participate in postsecondary studies. The costs of a psycho-educational assessment or
other disability assessment may also be considered.
Use this application to be considered for funding during the 2020-21 academic year as follows:
• up to $2,000 from the Ontario Bursary for Students with Disabilities (BSWD); and
• up to $20,000 from the Canada Student Grant for Services and Equipment for Students with
Permanent Disabilities (CSG-PDSE).
Who is eligible
Your eligibility for funding consideration is based on your disability status:
• For the BSWD, you must have either a permanent or a temporary disability.
• For the CSG-PDSE, you must have a permanent disability.
Denition: Permanent disability
A permanent disability is a functional limitation that:
• is caused by a physical or mental impairment,
• restricts your ability to perform the daily activities necessary to participate in studies at a
postsecondary level or the labour force, and
• is expected to remain with you for your whole life.
In addition, you must have applied for and be eligible for funding from one of the following sources for
your 2020-21 study period:
• Ontario Student Assistance Program (OSAP) for Full-Time Students
• OSAP for Part-Time Students
• An Institution-Funded Special Bursary (students at public universities and colleges in Ontario
only)
How your disability-related educational costs are considered
2
March 12, 2020
Note:
• Services and equipment may not be considered for BSWD and/or CSG-PDSE funding if:
• They are provided by your school.
• They are eligible for funding through another agency.
• They are eligible for funding by any third party, such as through insurance
• The cost of tutoring services provided by family members will not be considered for BSWD and/
or CSG-PDSE funding.
• The cost of tutoring services provided by individuals with a close personal relationship with the
student may not be considered for BSWD and/or CSG-PDSE funding.
• A request for a computer (desktop, laptop or tablet) will only be considered for funding once
every four years.
• Approved equipment and/or software must be purchased within 30 days of receiving your
funding.
• All approved items must be purchased before the end of your 2020-21 study period. Otherwise,
you will have to repay all or a portion of the funds given to you to make these purchases.
• Any services and/or equipment purchased before your application is approved are done so at
your own risk as they may not be approved for funding.
• The costs for services and equipment (excluding psycho-educational assessments) purchased
more than 60 days before the start of your study period will not be considered. Psycho-
educational assessment costs will not be considered if the assessment was performed more
than 6 months before the start of your study period.
Documentation you will have to provide
Documentation is required to conrm that, due to your disability, the services, equipment and/or
assessment selected on your application are needed so you can go to school. See Section D for
details.
When you are submitting your application
After you’ve been approved for funding
You will have to provide original receipts showing that you purchased the items that you were
issued BSWD and/or CSG-PDSE funding. Further instructions will be provided once your funding is
released.
Where to send your application
If you’re going to a school in Ontario:
Send your completed application and all required documents to your school’s nancial aid oce.
If you’re going to a school outside of Ontario:
Send your completed application to your school’s nancial aid oce so they can complete Section H.
When you receive your application back from your school, send it along with all required documents
to:
Student Financial Assistance Branch
Ministry of Colleges and Universities
PO Box 4500, 189 Red River Road, 4th Floor
Thunder Bay, Ontario
P7B 6G9
3
March 12, 2020
Contact the ministry at:
Student Financial Assistance Branch
Ministry of Colleges and Universities
PO Box 4500, 189 Red River Road, 4th Floor
Thunder Bay, Ontario
P7B 6G9
General inquiry telephone service is available Monday to Friday, 8:30 AM - 4:30 PM (Eastern
Time)
• Telephone: 807-343-7260.
• Toll-free in North America: 1-877-OSAP- 411 or 1-877-672-7411
• TTY: 1-800-465-3958
Deadlines
Application and supporting documents
Your completed application must be received by your nancial aid oce or the ministry no later than
60 days before the end of your study period.
All supporting documentation must be received no later than 40 days before the end of your study
period.
Proof of purchase for approved assessments, services and/or equipment
Original receipts for each approved item must be received by your nancial aid oce or the ministry
no later than 30 days after the end of your study period. If you received funds for services (e.g. tutors,
note-takers), you must also provide a time log that lists when each of the approved services was
used.
Note:
If you don’t provide acceptable proof and/or the purchase price was less than the approved funding
amount for an item, you will have to return all or a portion of the funds issued. Contact your nancial
aid oce for details.
Help with your application
If you’re going to a school in Ontario:
The Oce for Students with Disabilities or the nancial aid oce at your school can help you with
any questions about this application. The disability advisors there can also provide information about
disability-related services, supports and equipment available at your school.
If your school does not have an Oce for Students with Disabilities, you can discuss your disability-
related educational needs with your health care provider (doctor or other regulated health care
professional).
If you’re going to a school outside of Ontario:
4
March 12, 2020
2020-21
Ontario Bursary for Students with Disabilities (BSWD)
Canada Student Grant for Services and Equipment for
Students with Permanent Disabilities (CSG-PDSE)
Section A: Student information
First name:
Your mailing address
Section B: Information about your school and program
Last name:
Social Insurance Number: Ontario Education Number (OEN), if assigned to you:
Date of birth:
Street number and name, rural route, or post oce box: Apartment:
City, town, or post oce:
Province or state:
Postal code or zip code:
Area code and telephone number:
What is the name of the school you plan to attend or are currently attending for your
2020-21 study period?
Student number at your school:
What are the start and end dates of your 2020-21 study period?
From:
To:
For the above study period, what type of nancial aid have you applied for?
OSAP for Full-Time Students
OSAP for Part-Time Students
Institution-funded Special Bursary
Street number and name, rural route, or post oce box:
Country:
Day Month Year
Day Month Year Day Month Year
5
March 12, 2020
Section C: Request for assessments, services, and/or equipment
Select the items required to accommodate your disability-related needs while you’re in postsecondary
studies. If additional space is needed to outline the type of services and/or equipment required,
provide the information in a separate letter and attach it to your application.
A cost estimate must be provided for each item requested. Include taxes and shipping (if applicable)
in the amount provided. Enter amounts in dollars only. Do not enter cents or use periods or commas.
Each category may be subject to a funding cap. This means that not all your costs may be covered
even if your application is approved.
Assessments
Psycho-educational assessment
Other disability assessment (eligible for BSWD funding only)
Tutor
Note-taker
Academic strategist/coach
Attendant care for studies (while at school for course activities)
Educational assistant (while at school)
Specialized transportation (for students with mobility issues only)
Counselling/therapy (eligible for BSWD funding only)
Other - Specify:
Services
$
$
$
$
$
$
$
$
$
$
A written estimate for service requested is required. See Section D for details.
Work with a disability advisor at your school or your health care provider (doctor or other regulated
health care professional) when completing Section C.
Note to students attending a public university or college in Ontario
You must work with an advisor in the Disability Services Oce at your school when completing
Section C.
Note to students attending a private school in Ontario or any school located outside of Ontario
6
March 12, 2020
Computer equipment
Computer (including warranty, if applicable)
$
Indicate format required (select one only)
Laptop
Tablet
Desktop
All-in-one printer (printer/scannier/copier)
External monitor
External keyboard
Carrying case
Other - Specify:
Computer software and accessories
$
$
$
$
$
Text to speech software
Voice recognition software
Screen reading software
Assistive writing software
Other - Specify:
Assistive software
Organizational software
$
$
$
$
$
$
7
March 12, 2020
Reading pens/accessories
Noise cancelling headphones
Digital recorder
Equipment repair/replacement
Ergonomic aids (eligible for BSWD funding only)
Total amount requested:
Other - Specify:
Assistive equipment
$
$
$
$
$
$
$
You must provide the following documents (as applicable) to support your application:
Section D: Required documentation
An OSAP Disability Verication Form (if you have not already done so).
A written recommendation from a disability advisor at your school and/or your health care
provider (doctor or other regulated health care professional) for the services and/or equipment
requested if it was not provided on your OSAP Disability Verication Form.
Estimates for the costs of any requested service(s), such as tutors or note-takers. Each
estimate must include the following:
• hourly cost of each service;
• total hours per week of each service (cannot exceed weekly in-class time);
• total number of weeks you will be using each service;
• which of the courses you are taking require the service; and,
• the name and contact information for the person or agency providing each service.
Original receipts for any assessments, services, equipment and/or software requested if they
have already been purchased.
8
March 12, 2020
Section E: Student consents, declarations and signature
Notice of collection and use of personal information
Your personal information, including your Social Insurance Number (SIN), provided in connection
with your student prole, this application and any previous applications and awards of nancial
assistance will be used by the Ministry of Colleges and Universities (“ministry”) to administer and
nance the Bursary for Students with Disabilities (BSWD) program and by Employment and Social
Development Canada (ESDC) to administer and nance the Canada Student Grant for Services and
Equipment for Students with Permanent Disabilities (CSG-PDSE) program. Y
our SIN will be used as
a general identier in administering the BSWD/CSG-PDSE. The ministry and ESDC may use other
parties for any of these activities. Under agreement with the ministry, your postsecondary school and,
where authorized by the ministry, its agents who administer OSAP and its auditors use your personal
information to administer the BSWD/CSG-PDSE.
Student's consent to the indirect collection, use and disclosure of personal information
(REQUIRED)
• I agree that until I provide receipts for and/or repay BSWD/CSG-PDSE funds provided to me,
and until any BSWD/CSG-PDSE overpayments are assessed and repaid, the ministry can,
without limitation, collect and exchange personal information about me that is relevant to the
administration and nancing of BSWD/CSG-PDSE with ESDC, my postsecondary school and
its authorized nancial administrators and auditors; the ministry’s contractors, auditors or other
authorized third party administrators; collection agencies operated or retained by the federal or
provincial government, and consumer reporting agencies.
• I understand that I can withdraw any consent I have given in this section by writing to the
Director, Student Financial Assistance Branch at the address above at any time before I accept
a BSWD/CSG-PDSE award. I understand that if I withdraw my consent it will aect my eligibility
for and the amount of BSWD/CSG-PDSE assistance.
Administration includes: determining your eligibility for a BSWD/CSG-PDSE award; verifying your
application and supporting documentation, including verifying nancial assistance provided under
any other ministry program; paying your award; verifying your award; auditing your le; assessing
and collecting overpayments; enforcing the legislation set out below and your agreements with
the ministry and ESDC; and monitoring and auditing your postsecondary school or its authorized
agents to ensure that they are administering the programs appropriately. In addition, administration
by the ministry includes public reporting on postsecondary education and training, including the
administration and nancing of student assistance programs; planning, delivering, evaluating and
monitoring student assistance programs for quality and improvements in both content and delivery;
conducting risk management, error management, audit and quality assessment activities; conducting
inspections or investigations; and conducting research related to postsecondary education and
training, including all aspects of the BSWD/CSG-PDSE. You may be contacted to participate in
surveys related to postsecondary education and training. Financing includes: planning, arranging or
providing funding of the BSWD/CSG-PDSE.
The ministry administers the BSWD under the authority of ss.5, 15 and 16 of the Ministry of T
raining,
Colleges and Universities Act, R.S.O. 1990, c.M.19, as amended and s. 10.1 of the Financial
Administration Act, R.S.O. 1990, c.F.12, as amended, and the CSG-PDSE under the authority of the
Canada Student Financial Assistance Act, S.C. 1994, c.28, as amended, and the Canada Student
Financial Assistance Regulations, SOR 95-329, as amended and s. 266.3(4) of the Education Act. If
you have any questions about the collection or use of this information, contact the Director, Student
Financial Assistance Branch, Ministry of Colleges and Universities, PO Box 4500, 189 Red River
Road, 4th Floor, Thunder Bay, Ontario, P7B 6G9, 807-343-7260.
9
March 12, 2020
• I require BSWD/CSG-PDSE funding for the cost of the disability-related services and/or
equipment identied on this application, and I will not receive nancial assistance from any other
source to cover these costs.
• I understand that I must use the BSWD/CSG-PDSE I receive for the equipment and/or services
identied on this application and that I cannot substitute for any other equipment and/or services
not identied on this application.
• I agree that I will provide receipts for equipment and software no later than 30 days after
being issued BSWD/CSG-PDSE funds, and I agree that I will provide receipts for services no
later than 30 days after the end of my OSAP study period. I will submit these receipts to my
postsecondary school’s Financial Aid Oce or to the ministry, as instructed on this application
form, and will show that BSWD/CSG-PDSE funds were spent for their approved purposes.
• I agree that if I do not submit receipts, I will repay, by money order or certied cheque to my
school’s Financial Aid Oce or to the Minister of Finance, any BSWD/CSG-PDSE funds that I
have not used for the OSAP study period identied on this application. I understand that failure
to do so may result in being restricted from receiving OSAP, including BSWD/CSG-PDSE
funding.
• I understand that I may be required to repay all or part of the BSWD/CSG-PDSE funds if the
information and any supporting documentation I provide in connection with this application is
found to be inaccurate or if any information I provide changes, including my OSAP study period
and/or my course load.
• I understand that information I provide in connection with this application will be veried and
audited and any change resulting from verication and audit may aect my eligibility for and the
amount of BSWD/CSG-PDSE funds provided to me, and that I may be required to repay all or a
part of the BSWD/CSG-PDSE funds.
• I have given complete and true information on this application form and I understand that if
I fail to provide complete and true information and/or fail to promptly notify my Financial Aid
Oce or the ministry through my account on the OSAP website or in writing of changes to any
information I have provided, including my disability and the services and equipment I need,
my address and/or nancial, academic, family, and/or OSAP study period status; or fail to full
any obligations respecting the repayment of any overpayments, the ministry may restrict me
from receiving OSAP, including BSWD/CSG-PDSE funding, and may take legal action and may
require me to repay any assistance that I received.
I have read and understood this section, including the notice of collection, use and disclosure
of my personal information and my signature attests to my consent to the indirect collection,
use and disclosure of my personal information.
Date:
Signature of applicant:
Student’s declaration
Day Month Year
Note: if you are completing this form electronically, use the “Fill & Sign” feature in Adobe Reader or
your PDF program to add your signature.
10
March 12, 2020
Section F: Declaration by the Oce for Students with Disabilities (at public
universities and colleges in Ontario only)
Date:Signature:
Date:Signature:
Name of nancial aid administrator:
Name of disability advisor:
Temporary
Permanent
I declare that based on the information provided on this application:
• The student requires the services and/or equipment selected to accommodate their disability-
related needs to participate in postsecondary studies; or
• The student is applying for funding to complete a psycho-educational assessment to verify their
disability status for OSAP purposes; and
• The costs indicated (estimated or actual) for each of the selected items are accurate.
Section G: Enrolment conrmation and declarations by Financial Aid
Administrator (at public universities and colleges in Ontario only)
I declare that:
• The student’s OSAP prole shows that their disability status has been veried.
• The student’s disability status on their OSAP prole has been veried as the option I have
indicated:
• The student has applied for and is eligible for funding under one of the following programs for the
study period programs for their current study period:
OSAP for Full-Time Students (has at least $1.00 of nancial need)
OSAP for Part-Time Students
Institution-funded Special Bursary
• The student has provided all required documentation for this application.
• The student is dened as being enrolled in full-time studies.
Day Month Year
Day Month Year
Note: if you are completing this form electronically, use the “Fill & Sign” feature in Adobe Reader or
your PDF program to add your signature.
Note: if you are completing this form electronically, use the “Fill & Sign” feature in Adobe
Reader or your PDF program to add your signature.
11
March 12, 2020
Section H: Enrolment conrmation and declarations by Financial Aid
Administrator (at private schools in Ontario or at schools outside of Ontario)
I declare that based on the information provided on this application, the student is enrolled and
registered for the study period indicated.
Date:
Signature:
Name of nancial aid administrator:
Day Month Year
Note: if you are completing this form electronically, use the “Fill & Sign” feature in Adobe Reader
or your PDF program to add your signature.
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2020-21 Ontario Bursary for Students with Disabilities (BSWD) (Collge Boral)

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Completed 15 November 2020

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