Application For Financial Assistance Part-Time Last revised June 2020
Section 7 - Applicant Consent and Declaration
Section 6A - Requested Need - You can enter an amount below or, if you leave it blank, a calculation will be done
Section 6 - Additional Information Required
Do you want to be considered for a Part-time Canada Student Loan?
Have you received a Part-time Canada Student Loan from a province other than Alberta?
I have defaulted on my previous Full-time or Part-time Canada Student Loan and/or Canada Apprentice Loan (CAL)
• If yes, you are not eligible to receive further student aid until your loans are brought up to date.
Are you a student with a permanent disability?*
• *If yes, and you have previously provided documentation to conrm your permanent disability, you do not have to submit more
documents with this application.
• If yes, you may qualify for the Canada Student Grant for Students with Permanent Disabilities.
• If yes, and you require assistive services or equipment, you may qualify for the Canada Student Grant for Student Services and
Equipment for Students with Permanent Disabilities.
• To apply for either Canada student grant, you must complete a Schedule 4. For assistance or more information,
see the Disability Advisor/Reviewer at your school.
NOTE: This student aid is intended to help cover the
cost of tuition, books, travel and daycare (if applicable).
Applicant Consent and Declaration continues on Page 5
Signatures Required on Page 5
Total Part-time assistance requested $
Advanced Education is collecting this personal information under the authority of sections 33(a) and (c) of the Freedom of Information and
Protection of Privacy Act (Alberta) to determine and verify your eligibility for nancial assistance, to administer (including research, statistical
analysis, and evaluations) and to enforce student nancial assistance programs in accordance with the Student Financial Assistance Act
(Alberta), the Canada Student Loans Act and the Canada Student Financial Assistance Act, each as may be amended from time to time.
The use and disclosure of your personal information is managed in accordance with the Freedom of Information
and Protection of Privacy Act (Alberta).
If you have any questions about the collection, use or disclosure of this information, call the Alberta Student Aid Service Centre toll free
at 1-855-606-2096 from anywhere in North America. You can also email your questions to the Alberta Student Aid Privacy Ofcer at
I declare that:
• the information provided by me in this Application, and all
applicable schedules, is true and complete, including all nancial
information, and I understand that the information that I have
provided is subject to review and assessment by the Minister
of Advanced Education in accordance with the Student Financial
Assistance Act (Alberta), the Canada Student Loans Act and the
Canada Student Financial Assistance Act.
• I will use any nancial assistance awarded to me towards
the cost of my education.
• I have not applied to another province or territory for student
nancial assistance for the same period for which I am applying
for funding in this Application.
I agree to:
• provide information or documents as requested by Advanced
Education to verify any statements made in this Application.
• immediately notify Advanced Education in writing of any change
in my address, marital or common law partner status, nancial
circumstances, academic status or study period.
• repay my loan in full.
I understand that:
• I may be required to immediately repay any nancial assistance
I receive if there are any changes to my nancial circumstances,
marital or common law partner status, academic status or
• I may be denied nancial assistance if I fail to notify Advanced
Education in writing of any change in my nancial circumstances,
marital or common law partner status, academic status or study
period, or fail to provide documents or information as requested
by Advanced Education to verify statements made in this
• if I make a false or misleading statement in this Application,
or fail to disclose information as requested by Advanced
Education, I may be denied nancial assistance, and/or required
to immediately repay all nancial assistance received, and/or
subject to criminal prosecution.
• I am not entitled to apply for or receive nancial assistance from
another province or territory for the same period of time that I am
getting nancial assistance from Advanced Education.
• failure to disclose information or provide updated information
as requested by Advanced Education may constitute the making
of a false or misleading statement.
• Advanced Education has the right to recover benets I receive
which I am not entitled to, including any benets received due
to administrative errors.