Bursary Bursary This field is required.- Select -JIBC General Student BursaryYouth in Care Tuition BursaryPersonal Information Legal Surname/Family Name This field is required. Legal First Name This field is required. Date of Birth Gender This field is required.- Select -MaleFemaleTransgenderOther Please Identify Personal Contact InformationPersonal Contact Information Email This field is required. Phone Address Address 2 City/Town Province - None -AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNova ScotiaOntarioPrince Edward IslandSaskatchewanNortrh West TerritoriesYukonNunavut Postal Code Country CanadaAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua & BarbudaArgentinaArmeniaArubaAscension IslandAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia & HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBritish Virgin IslandsBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCanary IslandsCape VerdeCaribbean NetherlandsCayman IslandsCentral African RepublicCeuta & MelillaChadChileChinaChristmas IslandClipperton IslandCocos (Keeling) IslandsColombiaComorosCongo - BrazzavilleCongo - KinshasaCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d’IvoireDenmarkDiego GarciaDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard & McDonald IslandsHondurasHong Kong SAR ChinaHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacao SAR ChinaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmar (Burma)NamibiaNauruNepalNetherlandsNetherlands AntillesNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorthern Mariana IslandsNorth KoreaNorth MacedoniaNorwayOmanOutlying OceaniaPakistanPalauPalestinian TerritoriesPanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandsPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSamoaSan MarinoSarkSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia & South Sandwich IslandsSouth KoreaSouth SudanSpainSri LankaSt. BarthélemySt. HelenaSt. Kitts & NevisSt. LuciaSt. MartinSt. Pierre & MiquelonSt. Vincent & GrenadinesSudanSurinameSvalbard & Jan MayenSwedenSwitzerlandSyriaSão Tomé & PríncipeTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad & TobagoTristan da CunhaTunisiaTurkmenistanTurks & Caicos IslandsTuvaluTürkiyeU.S. Outlying IslandsU.S. Virgin IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamWallis & FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Alternative phone number Work phone To help us better meet your needs, please describe any disability(ies) / special requirements Citizenship StatusAre you a Canadian Citizen? Yes No Please indicate country of citizenship Please indicate your official status in Canada - Select -Permanent ResidentStudent VisaOther Visa or PermitRefugee / Convention RefugeeLive In CaregiverNon-Canadian studying Outside of CanadaIndigenous StatusDo you identify yourself as an Indigenous person? Yes No Indigenous status Status Non Status Please indicate if you are - None -First NationsMetisInuit Please provide your Band name (if applicable) Academic Information What is your JIBC student number?? JIBC Program Name This field is required.- Select -Advanced Care Paramedicine DiplomaCertificate in Applied LeadershipCertificate in Conflict Resolution: Specialization in Mediation_Third-Party InterventionCertificate in Conflict Resolution: Specialization in NegotiationCollaborative Conflict Resolution CertificateCommunity Care Licensing Advanced Specialty CertificateCritical Incident Stress ManagementEmergency Management CertificateEmergency Management Exercise Design CertificateEmergency and Security Management DiplomaEmergency and Security Management BachelorFamily Mediation CertificateFire Officer CertificateFire Safety StudiesFire Prevention Officer CertificateFire Fighting Technologies CertificateGraduate Certificate Complex Trauma & Child Sexual Abuse InterventionGraduate Certificate Cybercrime Analysis Graduate Certificate Intelligence AnalysisGraduate Certificate Tactical Criminal AnalysisInvestigation & Enforcement Skills CertificateLaw Enforcement Studies DiplomaLaw Enforcement Studies BachelorPrimary Care Paramedicine Certificate Career Goal Licences Financial InformationGeneral Current Situation - None -Single with dependentsSingle without dependentsMarried or in a common law relationship with dependentsMarried or in a common law relationship with no dependents Which best describes your current situation? Residence - None -Alone paying rentAlone paying mortgageWith others paying rent or mortgageWith others not paying rent or mortgage Where will you be residing during your study period? Other People - None -ParentsFamilySpouseFriends If you are living with other people who are they? Dependants - None -012345 How many dependents do you have? What are their ages? Loan Have you applied for government student loans for this study period? - None -YesNo Please include StudentAid BC or any out-of-province government student loans. If yes, what is the total loan funding for the study period If no, please explain why not Do you have outstanding government student loans from previous post‐secondary studies? If so, please indicate the total amount currently outstanding. Have you applied for a Student Line of Credit from a bank / credit union for this study period? - None -YesNo If yes, what is the total amount approved? Savings Do you have an RESP (Registered Education Savings Plan) that you will use for this study period? - None -YesNo If yes, what is the total amount of RESP savings to be used for this study period? Savings prior to start date of this study period? Please include RRSP's, Investments, Stocks etc. and exclude tuition and book expenses. Income What was your total net income for last year? What was your spouse / partner's total net income for last year? What is your total net income from work for this study period? What was your total net income from work in the four months before starting class? What is your monthly income from child support? What is your monthly income from other government sources? Please include HRDC, unemployment insurance, social assistance, etc. Assistance What contributions will you receive from your spouse / parents / your family? What other scholarships / awards / bursaries are you receiving for this study period? Expenses What are your estimated tuition costs for this study period? Please include the cost of any books. What are your expected monthly cost for this study period? Please include the cost of any day care, nanny, etc. Statement Financial Statement Please describe any exceptional circumstances that have affected your ability to finance your studies. Please include details of any exceptional medical expenses, child care expenses or the need to pay fees for two residences in order to attend a particular JIBC campus. You may be asked to provide supporting documentation when your application is reviewed, but please do not send any documentation unless it is requested. [Maximum 250 words] Personal Statement Personal Statement This field is required. Please include any further information that you feel might help in deciding on the outcome of your application. [Maximum 250 words] DeclarationI hereby declare that the information given on this application is, to the best of my knowledge, correct and that I have read and understood the directions at the beginning of this application.Any misrepresentation may result in a penalty which could include, but is not limited to, expulsion from my program, ineligibility to be considered for future bursaries and forfeit of any outstanding bursaries. Furthermore, the JIBC Registration Office maintains the right to withhold grades and official transcripts and to put a notation on my permanent record. I authorize the JIBC Registration Office to verify any or all of the above statements if deemed necessary. I understand that:the JIBC bursary selection committee appointed will review my applicationI must maintain satisfactory completion of courses in my program.I give permission to the JIBC Registration Office:to use information from my Income Tax Return to verify information on my bursary application.to consult its own Student Information System for the purpose of ascertaining my academic standing and cumulative credits; also to confirm my status as either part-time or full time and to confirm my field of study. I confirm I understand the declaration above This field is required.- Select -YesNo
