UWO FULL-TIME UNDERGRADUATE SUMMER OSAP …

1 UNDERGRADUATE SUMMER 2018 Supplemental Form, February 5th, 2018) Page 1 WESTERN UNDERGRADUATE SUMMER 2018 SUPPLEMENTAL OSAP APPLICATION For students taking at least 60% of a full course load (or 40% or more for students who self-identify as having a permanent disability). Please refer to chart at the back of this form. Return to: Student Financial Aid Date Received _____ Western University Western Student Services Building, Room 1100 London, ON N6A 3K7 519-661-2100, PERSONAL INFORMATION Last Name First Name Student Number COURSE INFORMATION (For students on Letter of Permission, please contact 519-661-2100) Please indicate or .05 course in each applicable SUMMER session noted below: Course Name and Number Intersession SUMMER Evening SUMMER Day Distance Studies FINANCIAL DATA (Do not include HST/GST rebates; Child Tax Benefit; Continued Care and Support for Youth payments (formerly Extended Care and Maintenance payments); Universal Child Care Benefit; Ontario Child Care Benefit; Ontario Child Benefit Equivalent Savings Program; Rental Opportunity for Ontario Families (ROOF) program; Registered Disability Savings Plan (RDSP); Youth Employment Fund; Entrepreneurial grants to start a business; Any loans or grants received through OSAP funding, Any UWO Scholarships, Awards or Bursary) Do you expect to earn more than $5,600 in employment income during your SUMMER study period?

2 If Yes , estimate the amount of income you will earn during your 2018 SUMMER study period. Do not include income listed as scholarships, bursaries and awards, or government funding. $ Total gross income received from scholarships, bursaries, and awards during the SUMMER course(s) listed above. Do NOT include Western Scholarship, Award or Bursary funding. $ Do you have government benefits over the SUMMER study period? Please list total amount of government income to be received during the SUMMER course(s) listed above AND indicate the type of government income by checking the applicable box noted below: $ 1. Employment Insurance 2. Loss of Earnings Benefits (WSIB) 3. Ontario Disability Support Program 4. Ontario Works 5. Canada Pension Plan 6. Second Career 7. Canada-Ontario Job Grant 8.

3 Other (Specify): ACCOMMODATION DURING THE SUMMER TERM (for single students only) Where will you be living during your SUMMER study period? With Parents Other FOR MARRIED STUDENTS/SOLE SUPPORT PARENTS ONLY Is your partner taking 60% or more of a full course load during your SUMMER study period? If yes, where? _____ No Yes If yes, will spouse be taking a program of at least 12 weeks duration? No Yes Childcare costs during the SUMMER study period (ages 11 and younger), 12 years of age or older who have a disability $ Do you maintain joint custody? No Yes DECLARATION I declare the above information to be true and correct in all respects, and I will notify Student Financial Aid immediately in writing of any changes I make in the program I have outlined above, or in my financial status.

4 I authorize the exchange of information regarding the OSAP award within the Office of the Registrar, and offices and departments on campus as it relates to the administration or release of OSAP assistance. Signature_____ Date_____ OFFICE USE ONLY: Date Application Processed: Cost Code: Adjustment(s): Other: The personal information on this form is collected under the authority of the University of Western Ontario Act, 1982, as amended. To view the complete Personal Information Collection Notice, visit the online Academic Calendar at: UNDERGRADUATE Student Information Ontario Student Assistance Program UNDERGRADUATE SUMMER 2018 Supplemental Form, February 5th, 2018) Page 2 1) All UNDERGRADUATE students requesting financial assistance for the SUMMER session (May 2018 to August 2018) must complete a Western FULL-TIME UNDERGRADUATE SUMMER 2018 Supplemental OSAP Application.

5 Please refer to the chart below. If you are eligible for OSAP and have not previously applied for OSAP for 2017-2018, you must complete a 2017-2018 online OSAP application, in addition to this UNDERGRADUATE Supplemental Application . The web application can be found at 2) Students enrolling in one distance studies half course, one distance studies full course, or one evening half course ONLY must complete the OSAP Application for Part-Time Students web application, which can be found online at Once your application is submitted, please hand in your completed signature pages and required documentation (if any) to Western Student Services Building: Student Financial Aid, Room 1100. Part-Time Application and Supporting Documentation Deadline is 42 days prior to your study period end date. Students enrolling in one distance studies full course and have a permanent disability have the option to apply for FULL-TIME or Part-Time OSAP.

6 3) Please notify Student Financial Aid, immediately in writing, of any changes to your application. The SUMMER OSAP Change Form can be found in Room 1100 or Student Central, Western Student Services Building or by downloading the form at: Changes to your application can be mailed, or dropped off to Room 1100 or Student Central, Room 1120, Western Student Services Building. 4) Please ensure a timely application, as release of funding may be impacted by government deadlines. 5) PLEASE NOTE - False or misleading statements on your application may result in suspension of funding and prosecution. All applications are subject to audit. *Applications may take up to 6 weeks to process* SUMMER OSAP Deadlines: Full course, Intersession, Starting in May: May 14th, 2018 Half A Intersession: April 20th, 2018 Half B Intersession: May 15th, 2018 Full course, SUMMER Day, Starting in July: July 9thh , 2018 Half A SUMMER Day: June 7th , 2018 Half B SUMMER Day: July 3rd, 2018 Full course, SUMMER Evening: June 18th , 2018 UNDERGRADUATE Information: These examples are for guidance only (for more information please check Appointment Scheduler Notifications for Drop-In Availability via our website at If you experience any difficulties, please contact our help line at 519-661-2100) SUMMER COURSE Did you receive OSAP funding for Fall/Winter 2017-2018?

7 APPLICATION TYPE PERCENTAGE OF COURSE LOAD Intersession Yes Use SUMMER Supplemental OSAP Application . 60% Intersession No Not Eligible Not 12 Weeks 1 Intersession Yes Use SUMMER Supplemental OSAP Application . 100% 1 Intersession No Not Eligible Not 12 Weeks SUMMER Evening Yes or No Use OSAP for Part-Time Students Online Application. 30% 1 SUMMER Evening or Distance Yes Use SUMMER Supplemental OSAP Application . 60% 1 SUMMER Evening or Distance No You must submit an online 2017-2018 OSAP Application and SUMMER Supplemental OSAP Application . 60% SUMMER Day Yes Use SUMMER Supplemental OSAP Application . 60% SUMMER Day No Not Eligible Not 12 Weeks 1 SUMMER Day Yes Use SUMMER Supplemental OSAP Application . 100% 1 SUMMER Day No Not Eligible Not 12 Weeks Distance Studies Yes or No Use OSAP for Part-Time Students Online Application.

8 20% 1 Distance Studies Yes or No Use OSAP for Part-Time Students Online Application. 40% 1 Distance Studies if a student with permanent disability Yes Use SUMMER Supplemental OSAP Application . 40% 1 Distance Studies if a student with permanent disability No You must submit an online 2017-2018 OSAP Application and SUMMER Supplemental OSAP Application . 40%