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Financial Assistance Application

Please indicate the type of Program(s) you are applying for*
Identifying Categories
If applicable.
Background Information
Ontario Residency*
I.e. City/Town such as London or Ilderton
Do you have children*
First Generation Bursary Consideration
Are you the first in your family to participate in a post-secondary program?*
If you are the first person in your family to participate in post-secondary education, did your parents attend post-secondary studies, full-time or part-time, in or outside of Canada?
Signature Required, only if this statement is "TRUE" to your situation.
Indigenous Student Bursary Consideration
Would you like to self-identify as an Indigenous person? For the purposes of this voluntary self-identification question, an Indigenous person in Canada is anyone who reported being an Indigenous person, that is, First Nations, Metis, or Inuk (Inuit).*
Do you identify with any of the specific identities provided below?
Signature Required, only if this statement is "TRUE" to your situation.
Academic Program 
Academic Load*

When completing the expense questions below, please provide your monthly costs in the first column and cost incurred for the whole academic term in the second column (i.e. Fall/Winter = 8 months, Fall Term only = 4 months). Please ensure you complete this section accurately. Applications that are incomplete and/or those that do not fully disclose resources will be denied.
Food/Meal Plan
Utilities (heat, hydro, cable, internet, etc)
Personal Expenses (clothing, entertainment, etc)
Please specify.
Please specify.
Where will you be living for the Academic Year?*

When completing the Resource questions below, please ensure you complete this section accurately. Applications that are incomplete and/or those that do not full disclose resources will be denied. 

Note, OSAP information is not required as this will be automatically verified.
Parental/Family Contribution and RESP Withdrawal
Spousal Income
Your Employment Income for Academic Year
Government Income (ex. CPP, EI, ODSP, etc)
Brescia Scholarships/Awards
External Scholarships/Awards
Previous Savings or Expected Savings (ex. summer employment savings) as of your first day of class
Additional Financial Information
Do you have a line of credit?*
Have you applied for OSAP or other provincial funding for this academic year?*

Application, Declaration and Privacy of Information Release

ALL student information collected and recorded by Brescia University College at Western University is considered CONFIDENTIAL and will be released only to the student concerned or to University staff for use in the course of their duties, or with written consent of the student as outlined in Western's Guidelines on Access to Information and Protection of Privacy Policy, the Official Student Record Information Privacy Policy, and Brescia's Policy pertaining to the Release of Student Academic Record Information. Such authorization will be considered in effect until the student cancels the authorization.

I have read and agree to the following:

  1. I consent to the use of personal information provided on this application or accompanying documentation for the purpose of determining my eligibility.
  2. All information provided in connection with this application is subject to audit and verification by Brescia University College at Western University. I consent to the disclosure of information on this application to the Ministry of 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.
  3. If any information is found to be untrue, I agree to pay back any funds I have received as a result of the application.
  4. The value of any bursary or award I receive will be applied to my student account.
  5. The decision on my application for financial assistance and the amount of funding awarded, if applicable, will be communicated to me in writing or via my Western email account.
  6. I consent to the disclosure of my name, address, biographical data, faculty, academic programs, or any other personal information that confirms criteria to the donor of my bursary or award to be used in any publication associated with bursary/award.
  7. The information provided on this application is complete and accurate and I require additional funds to pursue my studies at Brescia University College.
  8. 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.