Name of your program/course Class hours per week
Start Date (YYYY/MM/DD) End Date (YYYY/MM/DD)
r Female r Male r X r Other r Canadian r Landed Immigrant r Other:
PleasesubmitcopyofPRcard
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Social Insurance Number Phone
Last name (family name) First name
Address
City Province Postal code
Email address
Gender Citizenship
Describe what you need the bursary money for:
continued on next page
Program/course information
Student ID
Personal information
r Rent r Own home r Live with parents r Single student (living with parents) r Single student (living alone)
r Separated/divorced/widowed r Married/common law (no children)
r Married/common law (with children) – number of children living with you: Their age(s)
r Single parent – number of children living with you: Their age(s)
Living arrangements
p: 604.871.7046
f: 604.871.7143
e: financialaid@vcc.ca
www.vcc.ca/financialaid
Broadway campus
1155 East Broadway
Vancouver, B.C. V5T 4V5
A bursary is non-repayable money given to students who:
1. Are registered in full-time/part-time studies at Vancouver Community College
2. Have no outstanding debts at Vancouver Community College
Emergency Bursary Application
Please note: (
a.) Bursary money is taxable; and
(
b.) It is recommended that you apply for StudentAidBC Assistance or Adult Upgrading Grant before applying for a bursary,
CO_COMA_0072_FINA_COVID19_20200326
MONTHLY INCOME STUDENT SPOUSE
Work
$
$
Social Assistance/Welfare
$
$
EI/HRDC
$
$
BC Bonus/Child Tax Benefit
$
$
Daycare Subsidy
$
$
Student Loan/Grant
$
$
Other Income: (Specify)
$
$
SUB TOTAL
$
+
$
TOTAL Family Income (A)
$
I have received: r Adult Upgrading Grant r Tuition-free course(s) r Student Loan/Grant $
I have not applied for the above because:
Savings in the bank: $ Other Investments (such as GICs, Term Deposits): $
Do you/your spouse own/lease a motor vehicle/car? r No r Yes Make/Model Year
TOTAL expenses (B)
$
TOTAL income (A)
$
= TOTAL Need
$
MONTHLY FAMILY EXPENSES
Tuition, books & supplies
$
Transportation
$
Daycare/Babysitting
$
Rent/mortgage
$
Food
$
Child support payments
$
Utilities (hydro/cable)
$
Credit card/loan pymts
$
Other Expenses
$
TOTAL EXPENSES (B)
$
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I certify that the above information is complete and correct. I give the Financial Aid Department permission to release
any of this information to a donor.
Approved: r Yes r No Fund # Fund Name $
Approved by: Date (YYYY/MM/DD) / / Rank # Family
Specified Unmet Need Max BCSAP Award Term:
FOR OFFICE USE ONLY:
Applicants Signature Date
Financial information
Budget information
Declaration
Emergency Bursary Application
(Continued)
p: 604.871.7046
f: 604.871.7143
e: financialaid@vcc.ca
www.vcc.ca/financialaid
Broadway campus
1155 East Broadway
Vancouver, B.C. V5T 4V5
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