Studying Outside Québec
Confirmation of Admission for 2015-2016
1121 (1 of 2)
This form must be completed by the following persons:
• Any student who has submitted an application for financial assistance to study
at an educational institution outside Québec
• An authorized person of the educational institution
To ensure that the financial assistance application is processed,
the student must return this form himself or herself to Aide financière aux études.
The student must fill out sections 1, 2 and 3 of the form.
Section 1 – Student’s Personal Information
Permanent code assigned by the Ministère
de l’Éducation, du Loisir et du Sport
Last name
Date of birth
First name
Y
M
D
Social insurance number
Section 2 – Educational Institution
Code assigned by the Ministère to the
educational institution (if known)
Name of educational institution
Number
Direction
Street
(North, South, East, West)
Municipality
Municipality (cont.)
Province
Postal code
Telephone number
Country
Area code
Section 3 – Program of Study
Code
Name of program of study
Sections 4 and 5 must be completed by an authorized person of the Registrar’s Office or financial assistance office of the educational institution,
or the person in charge of the program.
Section 4 – Educational Information for 2015-2016
For administrative purposes, Aide financière aux études divides the academic year into three sessions of approximately four months: the fall, winter
and summer sessions. Each session corresponds to a study period.
Each of the student’s study periods must be clearly indicated within the structure of Aide financière aux études’s academic year. The course start date will
enable you to determine which period to be indicated.
If your academic year is divided into four quarters (i.e. fall, winter, spring and summer), the winter and spring periods must be merged.
If your academic year is divided into three terms (i.e. fall, spring and summer), your spring term must be considered the winter study period.
If your academic year is divided into two semesters, to which a shorter summer session is added, the first semester corresponds to the fall study period
and the second to the winter study period.
You must not fill in the Other academic year section, unless you are unable to match your academic year to one of the structures described above.
Ministère de l’Enseignement supérieur, de la Recherche et de la Science
Aide financière aux études 1035, rue De La Chevrotière
Québec (Québec) G1R 5A5
22-1314-15A (rev. 15-02)
1121 (2 of 2)
Permanent code assigned by the Ministère de l’Éducation, du Loisir et du Sport
Section 4 – Educational Information for 2015-2016 (cont.)
Fall 2015
(Study period beginning between September 1 and December 31, 2015)
Y
MD
Start date of study period
Y
MD
End date of study period
Please indicate what the student’s main activity will be during the period in question.
University
Bachelor’s cycle
Master’s
Other training
Doctoral
Full-time studies
Full-time studies
Full-time studies
Full-time studies
Full-time practicum
Full-time practicum
Full-time practicum
Full-time practicum
Thesis or dissertation
Thesis or dissertation
Winter 2016
(Study period beginning between January 1 and April 30, 2016)
Y
MD
Start date of study period
Y
MD
End date of study period
Please indicate what the student’s main activity will be during the period in question.
University
Bachelor’s cycle
Master’s
Other training
Doctoral
Full-time studies
Full-time studies
Full-time studies
Full-time studies
Full-time practicum
Full-time practicum
Full-time practicum
Full-time practicum
Thesis or dissertation
Thesis or dissertation
Check this box if the winter and spring periods have been merged.
Summer 2016
(Study period beginning between May 1 and August 31, 2016)­­
Y
MD
Start date of study period
Y
MD
End date of study period
Please indicate what the student’s main activity will be during the period in question.
University
Bachelor’s cycle
Master’s
Other training
Doctoral
Full-time studies
Full-time studies
Full-time studies
Full-time studies
Full-time practicum
Full-time practicum
Full-time practicum
Full-time practicum
Thesis or dissertation
Thesis or dissertation
Other academic path
The course start and end dates must be between July 1, 2015 and October 30, 2016
Y
MD
Start date of course
Y
MD
End date of course
Please indicate what the student’s main activity will be during the period in question.
University
Bachelor’s cycle
Master’s
Other training
Doctoral
Full-time studies
Full-time studies
Full-time studies
Full-time studies
Full-time practicum
Full-time practicum
Full-time practicum
Full-time practicum
Thesis or dissertation
Thesis or dissertation
Section 5 – Signature of the authorized person of the educational institution
The official stamp or seal attests to the authenticity of the information reported.
Last and first names
Telephone number
Area code
Date
Y
Signature X
Extension
MD
Official
stamp or
seal