170 Doak Road Fredericton, NB
Documents to be attached at the end of the application. Please include a cover letter with your application.
Your name
Coop Membership #
Address of Applicant
Your email
Telephone Cell Telephone Landline
Eligibility ***Member/Owner must be in good standing*** Please check one appropriate category and fill in required information Applicant is a member/owner of FDCC Parent is a member/owner of FDCC Name and Membership number of Parent Legal Guardian is a member/owner of FDCC(please attach proof of guardianship) Name and Membership # of Legal Guardian Parent/Legal Guardian is a fulltime employee of FDCC(please attach proof of guardianship) Name and Membership # of Parent/Legal Guardian
I, the undersigned applicant, do solemnly affirm that the information I have freely given to the following questions is, to the best of my knowledge and belief, true, accurate and complete. I permit the Committee to verify any or all of the information that I have provided on the following pages if they deem necessary. Your name and date.
Name of Institution Location
Faculty/Course of Study for 2021-2022
Year of Study (Please select one) 1234post Graduate
1. ACADEMIC ACHIEVEMENTS
* If you are a graduating high school student and will be entering a Post Secondary Institution in the Autumn, please complete Section 1.1 only.
* If you are presently attending a Post Secondary institution, please complete Section 1.2 only.
1.1 ACADEMICS - HIGH SCHOOL GRADUATING STUDENTS ONLY Please provide a transcript of your graduating courses. Please calculate and indicate below an overall average if not included with your transcript.
1.2 ACADEMICS - POST-SECONDARY STUDENTS ONLY Please provide a transcript of your most recent year of study at your Post Secondary Institution. Please calculate and indicate below an overall average if not included with your transcript.
2. STUDENT RELATED EXTRA CURRICULAR ACTIVITIES List all high school/college/university sports at any level, student organizations, and student clubs/activities with which you have participated in during the past two years only. Clearly show any special involvement such as positions held, event organizer etc. (Some examples: student council, drama club, band, debating, yearbook) List the total time for the year (in hours) of participation with each activity.
3. COMMUNITY SERVICE List and attach an accompanying letter from each organization verifying your involvement with that organization (such as hospital, seniors' homes, SPCA, minor sport groups, Red Cross, etc.) with which you have volunteered time in the last two years as your contribution to the community in which you live. List the total time (in hours) volunteering with each organization.
4. FINANCIAL
4.1 Do you qualify under the New Brunswick Free Tuition Program? Please check yesno 4.2 Will you be working this summer to help finance your education? Please check yesno Please elaborate. 4.3 Will you be working during the academic year to help finance your education? Please check yesno Please elaborate. 4.4 Are you relocating or have you relocated to attend your Post Secondary Institution? Please check yesno Please elaborate.
4.5 FINANCIAL BREAKDOWN
INCOME
Summer Savings $
Parent's/Legal Guardian's Contribution $
Spouse's/Partner's Contribution $
RESP Contribution $
Scholarships (successful only) $
Bursaries (show total amount) $
Financial Awards (student loans) $
TOTAL INCOME $
EXPENSES
Tuition and Fees $
Books $
Transportation (provide details in Section #5) $
Special Equipment (provide details in Section #5) $
Residence (if living on campus) Room $ Meals $
Rent (if living off campus) $
Food (if living off campus) $
Other (provide details in Section #5) $
TOTAL EXPENSES $
Financial Assistance Required (Please complete the calculation below)
Total Expenses (from above) $
Minus (-) Total Income (from above) $
Financial Assistance Required $
5. DETAILS Explain in detail the income and expenses stated in Section #4. Your message (optional)
Please attach all files as PDF only
