IVAN and MARGARET
TOUTLOFF BURSARY
APPLICATION
College of Graduate Studies and Research
Room C180 Administration Building, 105 Administration Place, Saskatoon SK CANADA S7N 5A2
Telephone (306)966-5750, Fax: (306)966-5756
E-mail: [email protected]
University of Saskatchewan Bursaries is given on the basis of financial need to graduate students. This funding is not considered to be a
source of long-term funding for a graduate student’s program. Students who currently hold $7,500 or more in award or scholarship money
over the next twelve months are not eligible to apply for this funding.
Please print or type your application for all sections.
Section I: Personal Information
TITLE
FAMILY/ SURNAME / LAST NAME
PHONE:
GIVEN NAME(S)
EMAIL:
HOUSE/APT #, STREET NAME:
CITY:
MALE
PROVINCE:
COUNTRY:
POSTAL CODE:
FEMALE
CITIZENSHIP STATUS (indicate only one):
Canadian Citizen
Permanent Resident
Student Visa
Landed Immigrant
If not Canadian, Country of Citizenship:
MARITAL STATUS:
Single
Married
Common Law
No. of Dependants:
Section II: Academic Information
STUDENT NUMBER:
EMPLOYEE ID# (if applicable):
GRADUATE UNIT (Department/School/Centre/Division):
START DATE OF CURRENT DEGREE PROGRAM:
Masters
(Day-Month-Year)
PREVIOUS ACADEMIC STUDY
PERIOD OF STUDY
From
To
Month / Year
Month / Year
UNIVERSITY ATTENDED
Name of Institution
DEGREE
Doctoral
Please describe the stage you are at in your graduate program with regard to course work research and comprehensive
examinations, if applicable:
Section III: Financial Information
Please estimate your expenses and resources:
EXPENSES
Fees
RESOURCES
Amount ($)
Books / Academic supplies
Accommodations/Utilities
Food/Household supplies
Transportation
Health/Dental Fees
Clothing
Miscellaneous (specify):
8 month estimate
12 month estimate
Awards
Amount ($)
Teaching Assistant
Research Assistant
Student Loans
Spousal Income
Other Income
Support from Relatives
TOTAL:
TOTAL:
Please describe the circumstances that have put you in need of bursary assistance:
Additional Financial Information:
Please answer the following questions. Details should include amounts received and expenses incurred.
1. Do you support dependants? Yes
Details:
No
2. Do you receive support from your spouse/parent/relative? Yes
Details:
3. Do you hold a teaching assistantship? Yes
Details:
No
No
4. Do you hold any other job, inside or outside the University of Saskatchewan? Yes
Details:
5. Do you hold any Fellowship or other award? Yes
Details:
6. Have you previously applied for bursaries? Yes
Details:
No
No
No
Section IV: Declaration
I hereby make application for bursaries at the University of Saskatchewan and I declare that the information provided on this
form is complete and true to the best of my knowledge.
________________________________________________
(Applicant’s Signature)
DATE: _______________________________________
After completion of Sections I to IV, please submit your application form
to your supervisory or Graduate Chair.
Section V: To Be Completed by your Supervisor or Graduate Chair
To be considered for bursary funding, the department must respond to the following questions:
1. Is the applicant making satisfactory progress in the graduate program? Yes
Details:
2. Has the advisory committee met this year? Yes
Details:
No
No
If it has met, does the committee report say that the student’s progress is satisfactory? Yes
Details:
3. Is the department support accurately reported in the candidate’s application? Yes
Details:
No
No
4. Is the support provided to this student by your department consistent with your funding policy? Yes
Details:
No
5. Please indicate as accurately as possible, the expected date of degree completion for the student’s program (e.g. date of
Ph.D. exam, etc.):
(Day-Month-Year)
NAME (printed):
DATE:
SIGNATURE OF SUPERVISOR OR GRADUATE CHAIR: _______________________________________
Completed application forms are to be sent to the attention of the Director of Graduate Scholarships and Awards,
C180 Administration Building, 105 Administration Place, Saskatoon, SK S7N 5A2.