:/admin/finaid/Awards/Hardship/Emergency Covid 19 Hardship application form KH April 2020
COVID 19 Emergency Assistance Application
Please answer all questions fully. Incomplete applications may not qualify for Emergency assistance.
Students who are in attendance in the CNC Spring 2020 semester (or current Trades Foundations) will be
considered for funding. All applications are adjudicated to determine eligibility. Students must be in good
standing with all college departments in order to be considered eligible for funding.
The College of New Caledonia complies with the Freedom of Information and Protection of Privacy Act. The information provided will
be used solely to determine eligibility for emergency funding and for no other purpose.
Full Name:
Last Middle Initial First
Student Number:
Date of Birth:
(yyyy/mm/dd)
Address:
Address:
Postal Code
Phone Number:
E-mail Address:
Full time ____ Part Time ______Adult Upgrading ____
Program/semester
Trades: Foundations ____ Apprenticeship _____
CNC campus:
PG ___ Quesnel ___ Mackenzie ___ Lakes ___ Vanderhoof ___ Fort St. James ___
Note: Your Social Insurance Number will be requested if not already uploaded into your student record.
Canadian citizen? Yes ____ No ____
BC resident for 12 continuous months (excluding study period)? Yes ____ No ____
Self-identified person of Aboriginal ancestry? Yes____ No ____
____ First Nations ____ Metis _____ Inuit
Student with a documented permanent disability Yes ____ No ____
International Student? Yes ____ No ____
Living Arrangements:
Check one:
STUDENT living with parent(s)
STUDENT living on own
STUDENT w’ one dependent (18 or under)
STUDENT w’ more than one dependent. How many?
:/admin/finaid/Awards/Hardship/Emergency Covid 19 Hardship application form KH April 2020
Please describe how the current Covid-19 pandemic has caused a need for financial assistance:
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________________
Are you currently working? : Yes ___ No ___ Not working any longer due to Covid-19 ____
Are you currently receiving a StudentAid BC or other provincial loan for the spring 2020 semester? _____
Average MONTHLY EXPENSES Average MONTHLY INCOME: for Spring 2020 semester
TYPE
AMOUNT
TYPE
AMOUNT
HousingRent/Mortgage
Employment/Income
Utilities (phone, hydro,
cable)
BC Benefits:
EI/WCB/Income
Assistance
Food
Sponsorship/WorkBC
Debt Payment
Spouse’s Income
Transportation (car,
insurance, gas)
Money from
parent(s)/family
Medical/Dental
OTHER (describe)
Daycare/babysitting
OTHER: (describe)
TOTAL
TOTAL
Students receiving accumulative taxable benefits from CNC in the amount of $500 or more in a calendar year,
will be issued a T4A for income tax purposes.
I certify that the information submitted is true and correct to the best of my knowledge. I understand any
misrepresentation of this information may result in me having to pay back any funds I receive.
Student’s Signature: _____________________________ Dated: __________________________________
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