Indigenous Careers Award Application Form: Northern Lakes College

Indigenous Careers Award Application Form

GENERAL APPLICANT INFORMATION

NLC Student ID *

Birth Date *

First Name *

Middle Name *

Last Name *

Alberta Student Number (ASN)

Street Address or Apt/Box Number *

Town/City *

Province

Postal Code *

Phone Number *

Email *

Citizenship Status *

Canadian Citizen

Permament Resident

Landed Immigrant

Gender *

Name of Program Attending *

Program Start Date *

ADDITIONAL INFORMATION

Students must have aboriginal ancestry and be Status Indian/First Nations, Non-Status Indian/First Nations, Métis, or Inuit.(check the box that applies) *

If yes, please also provide Nation/Band, Treaty or Settlement.

First Nation

Metis

Inuit

Proof of ancestry

Students must provide proof of their Indigenous ancestry to their institution before their eligibility is determined. Acceptable forms of proof may include one of the following, however institutions may use discretion and accept other documentation (e.g. proof that an ancestor’s name has been entered in the Indian Registry according to the Indian Act or as a beneficiary of the Nunavut Land Claims Agreement) on a case by case basis:

certificate of Indian Status, a status card or a band membership card
letter from their band verifying their status
membership card issued by a Métis organization the student is registered with (Metis organization must be a legal entity)
a certified copy of a Nunavut Trust Certificate card or Inuit beneficiary card
letter of support from Indigenous and Northern Affairs Canada or Nunavut Tunngavik Incorporated
a letter of support from an First Nation, Metis or Inuit organization (must be a legal entity) confirming the applicant’s aboriginal ancestry

Attach files: proof of ancestry *

Choose File No file chosen

The maximum total size of all files in a single form submission is 1 GB.

Additional criteria

If there are more applications than there are funds to be disbursed, additional criteria may include: academic achievement and/or community involvement.

All applicants will be notified, after the deadline, if additional information is required to be submitted.

APPLICANT DECLARATION

I have read and understand the instructions, and I hereby declare that the information in this application and its attachment(s) is correct and complete and I understand that it will be used in determining my eligibility for this award.

Please note that it is the applicant’s responsibility to ensure that all documentation and the full application (all sections) are received in the Student Awards office for consideration by the deadline.

I will immediately notify Northern Lakes College if there are any changes to the information I have provided in this application, and/or documents submitted.

The personal information that you provide to Northern Lakes College is collected under the authority of the Post-Secondary Learning Act, Section 65, the Income Tax Act (Canada), and Section 33(c) the Freedom of Information and Protection of Privacy Act (Alberta) ("FOIPPA"), and is protected under Part 2 of the latter act. This information will be used and disclosed for the purposes including determining eligibility for awards issued by Northern Lakes College. Collected personal information is protected from unauthorized access, collection, use, and disclosure in accordance with FOIPPA and may be reviewed subject to the provisions of the Act. If you have any questions about the collection of this information, contact the Student Awards Administrator, 780-849-8723, awards@northernlakescollege.ca or FOIP Coordinator, 780-751-3259, foipcoordinator@northernlakescollege.ca or 1201 Main Street SE Slave Lake, AB T0G 2A3.

I authorize Northern Lakes College to disclose the information collected on this application form, my program of study and any award details (if I am selected) to Alberta Student Aid, and I authorize Alberta Student Aid to collect this information from Northern Lakes College for the purposes of administering the Indigenous Careers Award under the Student Financial Assistance Act, including confirming my eligibility and suitability for this award, for program evaluation and for research and statistics analysis.

Agree with Applicant Declaration *

Yes

Date of Declaration *

Information provided by the student on the award application may be shared with award donors.

Please note that it is the applicant’s responsibility to ensure that all documentation and the full application (all boxes filled in that are applicable) are received in the Student Awards office for consideration by the deadline.

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