Rev. October 2020 Appendix 8 Request for Permanent Disability Programs
REQUEST FOR PERMANENT DISABILITY PROGRAMS
SECTION 1: ALL STUDENTS MUST COMPLETE THIS SECTION
Student First Name Initial
StudentAid BC Application Number
Personal Education Number (if known)
Date of Birth
Year Month Day
Postal Code/Zip Code Area Code Telephone Number
Date Classes Start Date Classes End
Year Month Day Year Month Day
Citizenship Status (Mark one box only)
YOUR PERMANENT DISABILITY STATUS MUST BE APPROVED BY
STUDENTAID BC AT LEAST 6 WEEKS BEFORE THE STUDY PERIOD END DATE.
SECTION 2: DECLARATION – IMPORTANT DOCUMENT; YOU MUST READ, SIGN AND DATE
I am applying for assistance under any one or more of the permanent disability programs outlined in this appendix.
I UNDERSTAND THAT THIS APPENDIX FORMS PART OF MY APPLICATION FOR STUDENT FINANCIAL ASSISTANCE AND AS SUCH INCLUDES ALL TERMS AND CONDITIONS AS
STATED IN THE FULL TIME OR PART TIME STUDENTAID BC APPLICATION DECLARATIONS.
In addition to the terms and conditions stated in the Full Time or Part Time StudentAid BC Application Declarations, I also understand that;
1) If I receive money to pay for educational related specialized services through the Canada Student Grant for Services and Equipment for Persons with Permanent Disabilities (CSG-PDSE) while
at a public or private post-secondary institution, or the Assistance Program for Students with Disabilities (APSD) program while at a private post-secondary institution, I will provide to
StudentAid BC, at the end of my study period, receipts showing that the funds were spent for their intended purpose, and will repay any unused funds to the British Columbia
Minister of Finance.
2) If I am attending a post-secondary institution in B.C., I will only request funds from the APSD program after I have exhausted all funds available through the CSG-PDSE.
3) I give permission to my physician or medical professional to disclose information directly related to my disability to the Ministry of Advanced Education, Skills and Training or Assistive
Technology British Columbia (The Board of Education of School District No. 39 (Vancouver) also known as Vancouver School Board) for the purposes or verifying or investigating information
pertaining to this application, and related documents, determining my eligibility for permanent disability funding.
4) I give permission to my school to disclose information to the Ministry of Advanced Education, Skills and Training or Assistive Technology British Columbia regarding my disability, access
requirements, academic standing, awards, living arrangements and financial status for the purposes of verifying or investigating information pertaining to this application and related
documents, determining my eligibility for permanent disability funding or determining whether I will be required to repay any funding I may receive.
5) If I am awarded a CSG-PDSE and/or a grant under the APSD, I authorize the institution I am attending or Assistive Technology British Columbia to cash the grant cheque(s) on my behalf
and apply the funds to retain a service worker and/or buy equipment and/or software on my behalf and/or apply the grant to the Learning Disability Assessment Bursary fund.
Date Signed (Year/Month/Day)
Collection and use of information. The information included in this form and authorized above is collected under Sections 26c and 26e 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 StudentAid BC. The information provided will be used to determine eligibility for a benefit through
StudentAid BC and for statistical and evaluation purposes. If you have any questions about the collection and use of this information, contact the Executive Director, StudentAid BC, Ministry of
Advanced Education, Skills and Training, PO Box 9173, Stn Prov Govt, Victoria B.C., V8W 9H7, telephone 1-800-561-1818 (toll-free in Canada/U.S.) or +1-778-309-4621 from outside North America.