Updated: Sept 2017
Place of Employment during Summer ______________________________ Position _________________________
Net Earnings $______________________ Summer Savings $__________________
Place of Employment (Academic Year) _____________________________ Position ________________________
Full-time Part-time Net Employment Earnings (monthly) $__________ x 8 = $_________________
Occupation of parent(s) ________________________________________ Annual Gross Income $____________
________________________________________ Annual Gross Income $____________
Occupation of spouse __________________________________________ Annual Gross Income $____________
Number of dependents in family _______________ Number attending university _____________
Do you live with your parents during the academic year? Yes No
If no, how many roommates do you have? __________
Please provide a full explanation of your financial circumstances. Explain why you wish to be considered for the
International Graduate Student Bursary. If there are special circumstances which limit the support provided by your
parent(s) or spouse, please explain. Limit is one page per application.
Declaration: READ CAREFULLY BEFORE SIGNING!
I declare that the foregoing information is, to my knowledge, a true, complete and accurate statement of my financial status, and I
hereby request consideration for assistance from the funds made available for this purpose by Saint Mary’s University.
I understand that the submission of false information may be subject to proceedings under the Discipline System for students (see
the current Calendar for the section on Student Discipline) and will result in the disqualification of my Application for an
International Graduate Student Bursary.
I authorize the release by Saint Mary’s University of information about any financial assistance that may be awarded to me as a
result of this application.
I authorize Saint Mary’s University to contact my sources of income for verification.
Signature: ______________________________________________ Date: ______________________________
Multiply all of your expenses by 12?
Total your expenses and resources?
→ Incomplete applications will not be considered!
→ International Graduate Student Bursary funds are applied to the student’s account.
→ Please do not call or drop by the office for results. The results of your application will be
mailed to you by the FGSR Office after the posted deadlines.
For Office Use Only:
Student Account Balance $____________________ QPA ____________________
Award Amount $____________________________ Date _____________________
Dean, Faculty of Graduate Studies and Research
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