Application For Financial Sponsorship

individual applicants

PROGRAM DESIRED

What PROGRAM or COURSE are you applying for? 

Education Achievements: Elementary to High School

Highest Grade Level successfully completed ( 1 to 12 )  Date Completed:  MM 01 02 03 04 05 06 07 08 09 10 11 12   DD 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31   YY 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020

Name of Last High School

Community of Last School   Province / Territory

GED Grade   Year Attained   YY 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020    ABE Level    

If yes, please specify: 

What are your Academic or Training Goals?

Within your current program, which year of studies are you going into?

  First Year                Second Year                Third Year                Fourth Year

N/A (You are in a program which takes less than one year to complete)

Previous Post-Secondary program enrolled in:

I have obtained, or will obtain sponsorship from the following sponsor's (please check boxes as appropriate):

What was Your Main Activity before applying for sponsorship?     Student        Employed       Unemployed

Employment prior to applying to the Mine Traing Society:

Please attach a resume with your application. 

Person to contact in case of emergency:         Relationship to you:

Street / P.O. Box No.       Community      Postal Code

Province / Territory     Phone No. (home)    (work)

The information is being collected pursuant to the authority of the Access To Information and Protection of Privacy (ATIPP) Act, Section 41. (1)(g). The Information will be used to determine my initial and continued eligibility for assisitances from the MINE TRAINING SOCIETY. The Privacy provisions of the ATIPP Act protect mny information

Personal Information is defined under the ATIPP Act section 2. All applicants have the right to examine and request correction of his/her records to request a review by the Information and Privacy Commissioner.

1. I declare that :

   a) The information given on this application, applicable documents, quotes or invoices are true and subject to audit

   b) I will immediately notify the MINE TRAINING SOCIETY, in writing, if my or my spouses personal information changes

   c) I will immediately notify the MINE TRAINING SOCIETY if i receive financial assistance from my source during the period of time I am receiving assistance form the MINE TRAINING SOCIETY.

2. I understand that :

   a) I will have to enter into an agreement with the MINE TRAINING SOCIETY and follow the terms and conditions therein if this application is successful.

   b) I will have to submit monthly reports to the MINE TRAINING SOCIETY during my enrollment and submit reports for one year after completion.

   c) The income that i receive from any source must be immediately reported and may affect the MINE TRAINING SOCIETY assistance i am receiving.

   d) I may have to immediately return any MINE TRAINING SOCIETY assistance funds i have received if there are/were changes to any personal information.

   e) If i make a false or misleading statement, I may be required to immediately repay all MINE TRAINING SOCIETY benefits and may e denied future benefits and face possible criminal prosecution.

   f) My personal information may be provided to nay of the possible funding programs within this application for the purpose of verifying eligibility for other financial aid programs and to detect fraud.

   g) the MINE TRAINING SOCIETY will contact other agencies to verify information I have provided as part of determining my initial and/or continued eligibility for MINE TRAINING SOCIETY financial assistance and to detect fraud. These agencies may include, but are not limited to the following: GOVERNMENT OF TE NORTHWEST TERRITORIES departments, federal, territorial or municipal governments. HUMAN RESOURCES AND SKILLS DEVELOPMENT CANADA including Canada Revenue Agency and Canada Citizenship and Immigration, Aboriginal agencies, management bodies, financial institutions, educational institutions and employers.

3. I consent to the release of personal information to the MINE TRAINING SOCIETY program by those agencies listed in 2 (g) above to verify any personal information provided to determine my initial and continue eligibility.