Emergency Fund Application

The Brescia Emergency Fund will assist Brescia students who are experiencing a significant short-term financial crisis. The Brescia Emergency Fund is not a source of long-term funding. A student should first reach out to the Financial Aid Officer at Brescia brfinaid@uwo.ca, before submitting this form, to discuss their individual situation.

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Student First (Given) Name*

Student Last (Family) Name*

Citizenship*

Student Number*

Western Email*

Current Mailing Address*

Immediate Financial Concern/Area of Assistance

Example of Eligible Expenses

Access to Wellness Resources
Access to food
Extenuating Circumstances (ex. Access to technology to support online/remote learning)

Example of Ineligible Expenses

Long-term Rent or Mortgage Coverage.
Discretionary Expenses (E.g. missed car payments, memberships or subscriptions).
Assistance with tuition
Loan Payments
Replacing total lost income (student, spouse, or caregiver)
Car repairs

Have you contacted the Financial Aid Officer at Brescia about your situation?*

Yes

Other

If you selected "other", please specify

Personal Statement

Please provide, in detail, the financial challenges you are experiencing.*

Process

Submit this application. You will be notified about the status of your application within 5 business days.
Funding is limited and meant to help supplement the unexpected expenses, but may not cover full amount of expenses
The Financial Aid Office may request additional supporting documentation/explanation of your circumstances as your application is considered.
Applicable funding support will be disbursed to students via cheque and mailed to the address provided above.
If you have completed an OSAP application for the academic year, please note that Brescia will report the amount of your bursary to OSAP on your behalf. This bursary is not considered a resource for OSAP assessment purposes. Therefore, it is exempt as study period income and your OSAP entitlement will not be affected due to this bursary.
Bursaries are considered to be taxable income and as such a T4A will be issued for the taxation year.

Student Declaration

The information provided on this application is complete and accurate and I require additional funds to pursue my studies at Brescia University College at the University of Western Ontario.
I consent to the use of personal information provided on this application or accompanying documentation, including my Social Insurance Number, for the purpose of determining my eligibility for financial assistance.
All information provided in connection with this application is subject to audit and verification by Brescia University College. I consent to the disclosure of information on this application to the Ministry of Training, Colleges, and Universities and any other source when necessary for audit and verification of the information provided. Documentation may be requested at a later date based on an audit.
If any information is found to be untrue, I agree to pay back any funds I have received as a result of the application.
I am aware that a change in my financial situation as outlined on my application, or change in my registration (ex. courses, program) may affect my bursary eligibility.

Student Electronic Signature*

Date*