Appeal Form

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2015 – 2016 SCSU GRANT APPLICATION
Please use ink. Read the additional instructions Page 4! Return the completed application to Registrar’s
Office (AA142). Incomplete applications and applications without appropriate documentation will not be
processed.
Please check one:
I wish to appeal the decision of the:
Textbook Grant Committee. My eService reference number is SCSU_______.
the Dollars for Daycare Grant Committee. My eService reference number is SCSU_______.
I am unable to apply using the eService grant application (due to a disability).
I have special circumstances and I missed the deadline for the eService grant application.
Applicant Information
Full
Name:
Last
First
Address:
Street Address
Apartment/Unit #
Prov.
City
Student
No:
Postal Code
Phone:
E-mail Address:
Marital Status
Status in Canada
Single
Canadian Citizen
Married/Common Law/Sole Support
Permanent Resident/Protected Person
Divorced/Separated
International Student
Current Study Term
Fall & Winter
Winter Only
Fall Only
Summer
Ontario Residency
I am an Ontario resident.
I am an out-of-province student. (Attach proof of provincial aid.)
If you have not completed an eService grant application, you must complete Page 2 (answer only those
questions applicable to you). Otherwise you may proceed to Page 3.
FAMILY INFORMATION
If single, do you live with your parent(s)/legal guardian(s)?
Yes
No
If you answered No and your parents live within 40 km of the university, provide an explanation.
If you have children who are financially dependent on you, please indicate how many and how old they are:
If you are single and have been out of high school less than 4 years, please provide gross annual income for
your parent(s)/legal guardian(s):
Parent/legal guardian #1: $
Parent/legal guardian #2: $
Number of dependents in the family:
Number attending university/college:
If you are married/common law, please provide your partner’s gross income: $
GOVERNMENT ASSISTANCE (OSAP, CSL or other government assistance)
Have you applied for assistance for the current study term?
Yes
No
Have you appealed your government award?
Yes
No
If you have not applied, provide explanation. If you have not applied for a student loan because of a
restriction (e.g. you defaulted on a previous loan), please indicate what steps you have taken to obtain
clearance.
EMPLOYMENT & OTHER RESOURCES
Did you apply for a bank loan or a student line of credit for this session?
Do you have a RESP?
Yes
No
Will your parent(s)/legal guardian(s) or partner be contributing to
your educational expenses?
Yes
No
Do you have a RRSP?
Yes
Yes
No
No
If yes, how much $
Did you work during the pre-study? The pre-study period refers to
the period 16 weeks preceding the start of your current study
term. Example: May to Aug for a Sept start date or Sept to Dec
for a Jan start date.
Yes
No
Are you working part-time during the current study term?
Yes
No
If you did not work during the pre-study, or were unable to save a reasonable portion of your earnings, please
provide the details:
Your Budget for the Current Study Term – Complete On Next Page





Single students should indicate only their income and expenses (not those of their parent(s))
Married students should indicate their total family income (after tax and other compulsory deductions)
and total family expenses.
# Months for Fall/Winter is 8 and for Fall or Winter or Summer, it is 4.
Do not write in the space Office Only
Round amount to the nearest dollar (e.g. $489.85 = $490)
ESTIMATED INCOME & RESOURCES
Savings (at the beginning of the session before any expenses are paid)
$
Net Income from your part-time job
$
Spousal Income (net income after deductions)
$
OSAP Funding (loan and grant) or Out-of-Province Financial Aid
$
Personal Loan or Bank Loan or Line of Credit
$
Family Support (include your RESP here, if applicable)
$
Scholarships and/or Grants (from U of T or external agencies)
$
Liquid Assets & Other Income (attach an itemized list)
$
TOTAL ESTIMATED INCOME& RESOURCES
$
ESTIMATED EXPENSES
Tuition & Incidental Fees
$
Books & Supplies *Attach a list of your textbooks, if appealing the textbook grant
$
Monthly
Expense
# Months
Public Transportation
$
$
Rent (or Residence - total for the current study term)
$
$
Phone
$
$
Groceries/Food (include snacks bought at school)
$
$
Internet
$
Toiletries/Personal Care (haircuts, make up, etc.)
Uninsured Medical/Dental (include only the amount not
covered by your Student Health Plan)
Childcare Expenses (provide details in your letter)
$
$
$
$
$
$
Other Expenses(not included above; specify)

$

$

$

$
TOTAL ESTIMATED EXPENSES
INCOME – EXPENSES =
Sign and date your application on Page 4.
$
$
TOTAL
Office
Only
TOTAL
Office
Only
Grant Appeal Procedures
1. Attach a letter explaining your special circumstances and grounds for appeal. If you had additional
expenses, you must explain the reason for each expense AND attach your receipts. For example, you had
uninsured medical or dental expenses (only reasonable costs for required treatment will be considered.
Orthodontic expenses (braces) will not be considered). You must provide receipts and the insurance
statements showing the uninsured amounts.
2. Complete the budget on page 3. Expenses and income should reflect your current study period. For
example Fall & Winter is 8 months; Summer is 4 months.
3. Out-of-province students must attach a copy of their provincial notice of assessment.
Procedures for Students Who Did Not Complete an eService Grant Application
1. If you missed the eService deadline, please attach a letter explaining the reason.
2. Complete all pages of this application. Expenses and income on the budget should reflect your current
study period. For example Fall & Winter is 8 months; Summer is 4 months.
3. Attach receipts for uninsured medical or dental expenses (only reasonable costs for required treatment
will be considered. Orthodontic expenses will not be considered). You must provide receipts and the
insurance statements showing the uninsured amounts.
4. Out-of-province students must attach a copy of their provincial notice of assessment.
Appeal or Application Deadline Dates
 Your grant award must be appealed within 30 days of the award decision. You can check eService for the
notification date.
Other Information
 You will be notified by email of a decision on your appeal or application within 4 weeks of your
submission.
 All awards will be deposited directly to your ACORN financial account. If your fees are paid in full and you
have a credit balance, you may contact Student Accounts at info.studentaccount@utoronto.ca or call 416978-2142 to have your refund processed.
 Add your bank account information on ACORN. By providing this information, U of T will be able to
electronically deposit any refunds, scholarships, grants or bursaries for which you are eligible (now and in
the future). Please note that U of T cannot withdraw money from your account.
Declaration & Signature
I hereby certify that the information provided on this application is, to the best of my knowledge, true and
complete, and I authorize the release of the information contained herein to the appropriate SCSU Grant Selection
Committee. I acknowledge that I am aware that making a false declaration is an academic offence for which
sanctions may be imposed.
I authorize the Financial Aid Office to access my OSAP application and assessment data when determining my
eligibility for bursary/grant assistance.
Signature:
Date:
The University of Toronto respects your privacy. Personal information that you provide to the University is collected pursuant to section 2(14)
of the University of Toronto Act, 1971. It is collected for the purpose of administering admissions, registration, academic programs, universityrelated student activities, activities of student societies, safety, financial assistance and awards, graduation and university advancement, and
reporting to government. In addition, the Ministry of Training, Colleges, and Universities has asked that we notify you of the following: The
University of Toronto is required to disclose personal information such as Ontario Education Numbers, student characteristics and educational
outcomes to the Minister of Training, Colleges and Universities under s. 15 of the Ministry of Training, Colleges and Universities Act, R.S.O.
1990, Chapter M.19, as amended. The ministry collects this data for purposes such as planning, allocating and administering public funding to
colleges, universities and other post-secondary educational and training institutions and to conduct research and analysis, including longitudinal
studies, and statistical activities conducted by or on behalf of the ministry for purposes that relate to post-secondary education and training.
Further information on how the Minister of Training, Colleges and Universities uses this personal information is available on the ministry’s
website. At all times it will be protected in accordance with the Freedom of Information and Protection of Privacy Act. If you have questions,
please refer to www.utoronto.ca/privacy or contact the University Freedom of Information and Protection of Privacy Coordinator at McMurrich
Building, room 104, 12 Queen's Park Crescent West, Toronto, ON, M5S 1A8.
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