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Emergency Funding Application

This application should be submitted by current University of Regina students who find themselves in a financial crisis.


Personal Information
Student First Name
Student Last Name
Student ID Number
Current Mailing Address
City
Province
Postal Code
Email Address
Phone Number

Have you ever applied for emergency funding at the U of R in the past?

Yes
No

How much funding do you need
(maximum $1,000):
$
What is this funding for
(list all that apply such as groceries, rent, etc):
Explain in as much detail as possible the extenuating circumstances that have led to your funding application (minimum 250 words):

Financial Disclosure - The total Income and total Expenses you have or will incur for this current term. This section is very important and must be filled out in full in order to assess your eligibility for emergency funding. If you know how much you receive/spend monthly on an item, then multiply that number by 4 for the whole term.

Please indicate what impact this funding will have on your education:

INCOME (FOR THIS TERM)

Student Loan Funding $
Scholarship/Award/Bursary $
Third-Party Assistance $
Employment $
Spouse/Partner Income $
Child Tax Benefit $
Other (explain) $
Total: $

EXPENSES (FOR THIS TERM)

Tuition $
Textbooks $
Rent $
Utilities $
Food $
Bus/Car/Gas $
Child Care $
Other (explain) $
Total: $ $

Declaration & Consent

I declare that the information I have provided in this application is true, complete and accurate. I understand that all information I have provided in connection with this application is subject to verification and audit by the University of Regina. I understand that I may only receive a bursary one time in my academic career at the U of R.

Privacy

I understand that personal information in connection with this application is collected under the authority of The University of Regina Act and is needed for administrative and statistical purposes. If you have any questions about the collection, use and disclosure of your personal information by the University of Regina, please contact the Associate Director, Enrolment Services, Room 108 Administration-Humanities Building, University of Regina, Regina, SK, S4S 0A2, 306.585.4591.

I understand that I am required to email my three last months of bank statements to safa@uregina.ca as supporting documentation of my finances in order for this application to be processed.