QFB Bursary Application Instructions 2015
Eligibility
This bursary is open to applicants as follows:-
1. A Quebec resident.
A proof of residence is required and a copy should be submitted with the application (i.e. Utility bill, Lease etc).
2. A registered blind person or a child of a registered blind parent or parents who are members of the Quebec Federation of the Blind Inc.
The member of the Quebec Federation of the Blind Inc. is a paid up member and a member in good standing.
3. A student who is enrolling either full time, part time, adult education program or is enrolled in a CEGEP, University or in a vocational training course leading to a degree or diploma.
Basis of Award
1. Preference will be given to members in good standing with the Quebec
Federation of the Blind Inc. If an applicant is not a member of the
Q.F.B., he/she must become a member. The Membership fee is $8.00
(eight dollars) for the year.
2. The awarding of the bursary will be based on scholastic ability and academic performance. Applicants will be asked to provide their most recent official transcript of marks.
3.
4.
This bursary is to be granted on a one year basis.
The maximum amount to be awarded per student in any one year is
not to exceed $1000.00 (one thousand dollars).
5. The bursary committee reserves the right to withhold awards for
any one year if there are no suitable applicants for assistance.

1.
2.
Documentation
The bursary application
Membership application for the Q.F.B. Inc.
Instructions
1. Applications are to be fully completed and returned to the Quebec
Federation of the Blind Inc. Bursary Committee at the above address.
2. You must submit with the application an official transcript with your marks from the two years of schooling prior to the current year and an official transcript once the final marks have been posted. Official transcripts must have the institution seal and be sent directly by the institution - NO EXCEPTIONS.
If the applicant is a mature student returning back to school and a transcript is not available, he/she must provide a copy of the acceptance letter from the institution.
Deadline
The application must be sent to the Quebec Federation of the Blind Inc.
Bursary Committee no later than MAY 31 of the year of application. The official final transcripts of the two last years must be received by the Quebec
Federation of the Blind Inc. Bursary Committee no later than JUNE 30 of
the year in which you apply.
Remember it is your responsibility to comply with these rules.
Extensions cannot and will not be given to any applicant who does not comply with these deadline and their application will not be considered. It is not the responsibility of the QFB to make sure that
all documents have been submitted by the allowable dates or period.
Notification
The decision of the bursary committee will be sent to all applicants by the beginning of September of the year of the application. Bursaries will be awarded to all successful applicants at the September opening dinner

Acknowledgement of Receipt
Any applicant who would like a confirmation of receipt of their application must send a self-addressed stamped envelope with their application. For any other information regarding the status of their bursary, only the applicant is allowed to contact the QFB office during regular business hours.
No calls will be accepted or information given out to anyone other than the applicant as required by the privacy laws of Quebec &
Canada.
The Quebec Federation of the Blind Inc. complies with the confidentiality laws at both the provincial and federal levels and will keep any and all information confidential. No information will be disclosed without the applicant’s written permission except to law enforcement or the Minister of Education.

Bursary Application 2015
General Information
Last name:
First Name:
Address:
City: Postal Code:
Telephone number:
Cell number:
Date of Birth:
Social Insurance Number: ___ ___ ___
Do you live with your parents? --
Are you a member of the Quebec Federation of the Blind? --
Are you legally visually impaired? : --
Is either of your parents legally visually impaired? : --
Education Background
Presently attending: University: CEGEP: High school:
Name of institution:
Address of institution: Postal Code:

City: Province: Country:
Current grade or level: Student ID#:
Education Plan
Education plan for the next school year:
Name of the institution you plan to attend:
Address of the institution you plan to attend:
Your Grade or Level: Field of study:
Work Experience
Date (From – To) Employer / Supervisor Address Position
Official Transcripts
I have included transcripts of my previous two years of schooling with this application. --
(Failure to include these transcripts may negatively impact the evaluation of the application if not received by June 30 of the year of application.
Declaration (to be signed by all applicants)
I hereby declare that all information provided is to the best of my knowledge correct and complete and can be verified upon request.
Signature: ______________________
Date:

REGULAR MEMBERSHIP APPLICATION
Surname_____________________Given Name_______________________
Address_______________________________________________________
City__________________ Prov._________Postal Code________________
Telephone: Home______________
Work____________
Mobile ______________
E-Mail__________
Date of Birth: Day/ Month/ Year__________/__________/______________
Date of Application: Day/ Month/ Year ________/_______/_________
Release of Name and Phone Number to Outreach Committee
Release my name and phone number to the outreach committee: Yes_ No__
OPTIONAL : Would you like the QFB office to know about any health problems? (Example: Diabetics, Heart Problem etc.) YES____NO____
If yes, please state____________________________________________
I, hereby agree to become a member of The Quebec Federation of the Blind
Inc. and to pay a sum of eight ($8.00) as an annual Fee (1 January to 31

December) and I further agree to be bound by the bylaws, rules and regulations of the Federation.
PLEASE TURN OVER
It is understood that I may resign from the Federation at any time by notifying the Office Manager.
SIGNATURE_______________________DATE_______________
OFFICE USE:
Passed Executive Meeting_____________________________