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2021/2022 Adult Upgrading Grant (Kwantlen Polytechnic University)

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Page 1 of 8

Adult Upgrading Grant

Application

2021/2022

ADULT UPGRADING GRANT

The Adult Upgrading Grant (AUG) provides needs-based support to students enrolled

in Adult Education Programs. This grant helps cover costs associated with applicable fees, books,

unsubsidized childcare and transportation for students most in need of financial assistance.

This grant also supports the cost of tuition for Adult Special Education programs.

WHO IS ELIGIBLE?

Applicants must:

• Be a Canadian Citizen, permanent resident, or protected person.

If you are not a Canadian Citizen, you must provide a copy of a Canadian immigration document

(IMM 1000, IMM 5292, IMM 5509, permanent resident card, or other Canada issued

documentation).

• Be a B.C. resident.

• Be enrolled in one or more of the following approved course(s): Adult Basic Education,

Adult Special Education, or English as a Second Language.

• Demonstrate financial need.

You and your spouse (if applicable) must provide a copy of your previous year's tax return or other

proof of income. If you are under the age of 22 and reside with your parent(s), your parent(s) must

provide proof of income.

Income is defined by the amount of yearly income (line 15000 of income tax return) and income

derived from assets such as investments, rental property, and businesses owned inside and outside

of Canada and monetary gifts.

Examples of proof of income may include:

• Notice of Assessment from Canada Revenue Agency

• Proof of income statement (option 'C' print)

• T4 Statement of Remuneration Paid

• T1 General (LINE 15000)

• T5007 Statement of Benefits

• ROE Record of Employment

• PAY STUB

• T5 Statement of Investment Income

• Letter from employer(s) verifying income amount

HOW DO I APPLY?

To apply for the Adult Upgrading Grant, you must complete this application. Once complete, you must attach all the

required information outlined above with the completed application and submit it to the Financial Aid Office at your post-

secondary institution. If you save this application to a computer used by other people, remember to delete this

application from the computer after you have sent it in to the Financial Aid Office.

When completing the application, please refer to page 2 (Application Instructions) for additional

information.

Please note: Section 7 of the application form is for Finance Aid Office use only. This section will

be used to determine your grant amount.

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Page 2 of 8

INSTRUCTIONS FOR COMPLETING THIS APPLICATION

Question

Instruction

1-12

Please provide your most up-to-date information.

Identify your Marital Status; choose one of the choices provided that best describes your status.

You are a single parent if you have custody of your child(ren), or your child(ren) live with you at least two days per week

during your entire study period.

A common-law relationship is a person with whom you are living in a marriage-like relationship for at least 12 continuous months;

s/he is the parent of your child by birth or adoption or has custody and control of your child (or had custody and control

immediately before the child turned 19 years of age) and your child is wholly dependent on this person for support.

Indicate whether you are a Canadian Citizen, Landed Immigrant/Permanent resident, or Protected Person/Convention

Refugee. You must attach a copy of the appropriate legal documentation (IMM 1000, permanent resident card, or other

legal documentation) that confirms your status or that your application for permanent resident has been successful.

15-16

Indicate whether you identify yourself as an Indigenous person and Indigenous identity group (optional).

Identify that you meet the B.C. residency requirement. You are a B.C. resident if:

• You have lived in B.C. all your life; or

• B.C. is the province where you last lived for 12 continuous months, as of your study start date, not including months of full-

time post-secondary study; or

• You arrived in B.C. as a permanent resident or landed immigrant, or protected person.

Identify that you have a Person With a Disability (PWD) designation as determined by the Ministry of Social Development

and Poverty Reduction.

A confirmation from the Ministry of Social Development and Poverty Reduction indicating that you have a PWD

designation may be required along with this application.

If ANY of the following criteria applies to you, check the "yes" box: "Yes" means you are an independent applicant.

• You are 22 years of age or older; or

• You are a single parent, common-law, married, divorced or widowed as indicated in question 13; or

• You have a PWD designation as indicated in question 18; or

• You do not currently live in your parent’s or legal guardian's home.

Guardian means the person who is charged with the legal right and duty of care for a person, including children, due to the

person’s inability (due to age, mental or physical inability) to care for him/herself.

If you answered “No”, it means you are a dependent applicant. Please have your parent(s) answer questions 22-24 where

applicable.

If you answered ‘yes’ for question 20, please include:

• Yourself

• Your spouse/common-law partner

• Your dependent children.

If you answered ‘no’ for question 20, please have your parent(s) or legal guardian(s) complete this section to include:

• The applicant (yourself)

• Your parents

• Your parents’/legal guardians’ dependent children under the age of 19 and dependent children over 19 with special needs.

22-23

Enter line 15000 from your 2020 income tax return. IF YOU DID NOT FILE INCOME TAX in 2020, go to question 23 and

indicate your total income as shown in your proof of income. If you answered "No" for question 20, have your parent(s)

answer questions 22-24 where applicable. If your income is above the income threshold listed in Section 2 and you

received the AUG between April 1, 2020 and March 31, 2021, please see Financial Aid Office to confirm your eligibility.

Other sources of income include income derived from assets such as investments, rental property and businesses owned

inside and outside of Canada, and monetary gifts.

The total of unsubsidized day-care cost is the amount of licensed childcare cost not covered by child care subsidy from other

agencies or governments.

Enter the amount of travel cost needed in order to attend the registered course or program during the study period.

Indicate the school and campus where you will be attending this period of study. Indicate the type of course(s), the course

dates and the number of course weeks. Course Type is categorized as follows: Adult Basic Education, English as a Second

Language, Adult Special Education.

2021/2022

Adult Upgrading Grant

Application instructions

Page 3 of 8

Adult Upgrading Grant

Application

2021/2022

SECTION 1: STUDENT INFORMATION

(01) Legal LAST NAME

(10) SOCIAL INSURANCE NUMBER

(02) Legal FIRST NAME and MIDDLE Initial(s)

(11) DATE OF BIRTH

YEAR

MONTH

DAY

(03) MAILING ADDRESS – IMPORTANT: All mail will be sent to this address

Apt/box/suite number

(12) STUDENT NUMBER

(4) Use this line for any part of your address not indicated above

(5) CITY/TOWN

(6)

PROVINCE

(07) POSTAL CODE

(13) Marital Status on the first day of classes

Single

Single Parent

Married

Common Law

Divorced/Separated/Widowed

(08) AREA CODE

( )

TELEPHONE NUMBER

(14) Citizen Status:

Canadian Citizen

(9) E-MAIL ADDRESS - Notifications MAY be sent to this address

Landed Immigrant/Permanent Resident

Protected Person/Convention Refugee

(15) Do you identify yourself as an Indigenous person, that is, First Nations, Métis or Inuit? (Optional) YES NO

(16) If you identify yourself as an Indigenous person, are you: (Optional) First Nations

Métis

Inuit

(17) Residency: Have you lived in B.C. for 12 continuous months, not including full-time post-secondary study? YES NO

(18) Do you have a Person With a Disability (PWD)

designation?

YES

(19) Will you be receiving a full-time BC-Canada integrated student loan for this study period? YES NO

(20) Select "YES" if ANY of the following criteria applies to you:

• You are 22 years of age or older;

• You are a single parent, married, common-law, divorced

or widowed as indicated in question 13;

• You have a PWD designation as indicated in question 18;

• You do not currently live in your parent’s home.

YES

(21) If you answered "YES" for question 20, list your dependents (if applicable); if you answered "NO" have your parents list you

and and your siblings (if applicable).

Name Date of Birth

Was this dependant claimed on your

2020 tax return?

YES

Page 4 of 8

Adult Upgrading Grant

Application

SECTION 2: INCOME (INSIDE AND OUTSIDE OF CANADA)

2021/2022

To be considered for the Adult Upgrading Grant, you must demonstrate financial need. Eligibility is determined based on

gross income and family size.

Family Size

Income Level

$30,600

$47,275

$53,001

$61,200

$68,424

$74,955

7 or more

$80,960

If the amount on line 15000 of your 2020 income tax return is above the income threshold and you received

the AUG between April 1, 2020 and March 31, 2021, please see the Financial Aid Office to confirm your

eligibility.

• DEPENDENT applicant must have parent(s) or legal guardian(s) complete the necessary income field.

• INDEPENDENT applicant must have spouse or common-law partner complete the necessary income field (if applicable).

APPLICANT

PARENT(S)/ LEGAL

GUARDIAN(S)

SPOUSE /

COMMON-LAW

PARTNER

(22) Reported income from line 15000 of 2020 income Tax Return.

Note: If you did not file a tax return in 2020, leave blank and

proceed to question 23.

.00

Parent 1

.00

Parent 2

.00

Note: question 23 should be left blank if you answered question 22.

You Must provide a copy of proof of income (see page 1).

(23) What was your gross income in 2020?

(Include wages/earnings, Income Assistance, Employment

Insurance benefits, Employment Program for Persons with

Disabilities income (EPPD), and any other source of taxable

income.)

.00

Parent 1

.00

Parent 2

.00

(24) Other sources of income (investments, rental property,

businesses inside and outside of Canada, and monetary gifts).

Note: All additional sources of income must be declared. Eligibility

is determined based on the total indicated on question 22 or 23

plus 24.

.00

Parent 1

.00

Parent 2

.00

It is the responsibility of the student to ensure that receiving the Adult Upgrading Grant does not

impact Income Assistance and Employment Insurance eligibility.

SECTION 3: EXCEPTIONAL EXPENSES (Complete only if applicable)

(25) Enter the total unsubsidized day-care costs you need during class hours for the study period.

.00

(26) Enter the total amount of travel costs needed to get to your class during the study period.

You may be required to provide documentation to support these estimates amount.

.00

Page 5 of 8

Adult Upgrading Grant

Application

2021/2022

SECTION 4: APPLICANT DECLARATION

This is the declaration and Canada Revenue Agency consent form. Read the declaration carefully. If you do not understand it, ask for

assistance at your financial aid office.

I am applying for financial assistance under the terms and conditions of the Ministry of Advanced Education and Skills Training.

I understand that by ticking the box below, it means:

1. It is my responsibility to make sure the information on this application, and/or all the documents forming part of it is accurate;

2. The post-secondary institution will determine the amount of money I may be eligible to receive;

3. It is against the law to make false or misleading statements on this application or all documents forming part of it;

4. If I do not provide complete, accurate information or if I obtain or attempt to access financial assistance by fraudulent means, I will

be denied the Adult Upgrading Grant;

5. All information is subject to audit and verification;

6. If I receive money and then it is discovered that my application, or documents forming a part of it, is not accurate, I may be

required to repay all or part of the money. I will be required to do this if the mistake was made by me, my spouse/common-law

partner, parent(s), legal guardian;

7. If I receive the Adult Upgrading Grant, a portion or all of the money may be sent directly to my school to pay educational fees.

8. I have read the instructions provided with this application;

9. I have accurately answered all questions on the application and all documents forming a part of it;

10. I certify that all information is complete and accurate and I have not altered or added to any of the application;

11. I need student financial assistance to continue my education; and

12. For the purposes of research and verifying information about this application and related documents, I agree to the collection, use

and disclosure of my personal information between the Ministry of Advanced Education and Skills Training, educational

institutions, financial aid offices, First Nations governments/bands, and federal, provincial, municipal ministries/departments/

agencies. This consent takes effect when I sign this Declaration.

Collection and use of information. The information included in this form and authorized above is collected and managed in accordance

with Section 26 of the Freedom of Information and Protection of Privacy Act and under the authority of the Canada Student Financial

Assistance Act, R.S.C. 1994, Chapter C-28 and the Ministry. The information provided will be used to determine eligibility for a benefit

through the Ministry. If you have any questions about the collection and use of this information, contact Ministry of Advanced Education

and Skills Training, PO Box 9173, Stn Prov Govt, Victoria, BC V8W 9H7, call 1-800-561-1818 (toll-free in Canada/U.S.) or 250 387-6100

(outside North America).

(IMPORTANT DOCUMENT – READ, SIGN AND DATE)

I understand.

APPLICANT NAME DATE SIGNED

Y Y Y Y /

M M

D D

CANADA REVENUE AGENCY CONSENT

For the purpose of verifying the data provided in this application for student assistance, I hereby agree to the release, by the Canada

Revenue Agency, to the Ministry of Advanced Education and Skills Training (or a person delegated by the ministry), of taxpayer

information from any portion of my income tax records that pertains to information given by me on any Ministry application. The

information will be relevant to, and used solely for the purposes of determining and verifying my eligibility for the Adult Upgrading Grant.

This authorization is valid for the two taxation years prior to the year of signature of this consent, the year of signature of this consent and

for any other subsequent consecutive taxation year for which assistance is requested.

(IMPORTANT DOCUMENT – READ, SIGN AND DATE)

I agree.

APPLICANT NAME

DATE SIGNED

Y Y Y Y /

M M

D D

Page 6 of 8

Adult Upgrading Grant

Application

2021/2022

SECTION 5: PARENT(S) OR LEGAL GUARDIAN(S) AND SPOUSE OR COMMON-LAW DECLARATION

I understand that by ticking the box below, it means:

1. The student will have access to information provided in this application form;

2. Post-secondary institution will have access to information provided in this application form;

3. It is against the law to make false or misleading statements on this application or all documents related to it;

4. It is my responsibility to make sure the information on this application is accurate;

5. All information is subject to audit and verification;

6. I certify that the information I have given is correct and complete and that I have not altered or added to any of the Adult

Upgrading Grant application and/or questions;

7. I have authorized the student to immediately notify the Financial Aid Office of the post-secondary institution of any increase in

my income; and

8. I consent to the exchange of information between the post-secondary institution and the Province of British Columbia about

my financial status. This consent will take effect when I indicate my agreement below.

For the purposes of verifying information about this application, I consent to the collection, use and disclosure of my personal

information between the Ministry of Advanced Education and Skills Training, educational institutions, financial aid offices, First Nations

governments/bands, and federal, provincial, municipal ministries/departments/agencies. This consent takes effect when I sign this

Declaration.

Collection and use of information. The information included in this form and authorized above is collected and managed in

accordance with Section 26 of the Freedom of Information and Protection of Privacy Act and under the authority of the Ministry. The

information provided will be used to determine eligibility for a benefit through the Ministry. If you have any questions about the

collection and use of this information, contact Ministry of Advanced Education and Skills Training, PO Box 9173, Stn Prov Govt,

Victoria, BC V8W 9H7, call 1-800-561-1818 (toll-free in Canada/U.S.) or 250 387-6100 (outside North America).

(IMPORTANT DOCUMENT – READ, SIGN AND DATE)

APPLICANT SPOUSE NAME (IF APPLICABLE)

DATE SIGNED

I understand.

Y Y Y /

M M

D D

APPLICANT PARENT/LEGAL GUARDIAN 1 NAME (IF APPLICABLE) DATE SIGNED

I understand.

Y Y Y Y /

M M

D D

APPLICANT PARENT/LEGAL GUARDIAN 2 NAME (IF APPLICABLE) DATE SIGNED

I understand.

Y Y Y Y /

M M

D D

Page 7 of 8

Adult Upgrading Grant

Application

2021/2022

SECTION 5: (continued)

APPLICANT SPOUSE (IF APPLICABLE)

APPLICANT PARENT/LEGAL GUARDIAN 1 (IF APPLICABLE)

APPLICANT PARENT/LEGAL GUARDIAN 2 (IF APPLICABLE)

I agree.

I agree to the release, by the Canada Revenue Agency, to the Ministry of Advanced Education and Skills Training (or a person

delegated by the ministry), of taxpayer information from any portion of my income tax records that pertains to information given by me

on any Ministry application. The information will be relevant to, and used solely for the purposes of determining and verifying the

student's eligibility for the Adult Upgrading Grant. This authorization is valid for the two taxation years prior to the year of signature of

this consent, the year of signature of this consent and for any other subsequent consecutive taxation year for which assistance is

requested.

(IMPORTANT DOCUMENT – READ, SIGN AND DATE)

APPLICANT SPOUSE NAME (IF APPLICABLE) DATE SIGNED

Y Y Y Y /

M M

D D

APPLICANT PARENT/LEGAL GUARDIAN 1 NAME (IF APPLICABLE)

DATE SIGNED

Y Y Y

APPLICANT PARENT/LEGAL GUARDIAN 2 NAME (IF APPLICABLE)

DATE SIGNED

Y Y Y

Page 8 of 8

SECTION 6: COURSE DETAILS

Adult Upgrading Grant

Application

2021/2022

(27) Indicate the school and campus where you will be attending this period of study. Indicate the type of course(s), the

course dates and the number of course weeks.

Name of Institution Campus

Course Type

Course

Code/Numbe

Course Name

Previously received

funding for this

course

Course

Start Date

Course

End Date

Number

Weeks

Yes

SECTION 7: FOR FINANCIAL AID OFFICE USE ONLY

Adult Upgrading Grant Recommendation

Tuition Fees Books Supplies

Transportation

Unsubsidized

Daycare

Total Award

$ $ $ $ $ $ $

Important : All funded activity must be reported through the electronic reporting system

APPROVED

DENIED

Financial Aid Officer Comments

FINANCIAL AID OFFICER SIGNATURE

MUST BE SIGNED

PRINT NAME

PRINT HERE

DATE SIGNED

Y Y Y

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