Lawrence S. Bloomberg Faculty of Nursing

Graduate Awards Application Form

Application Form
Information Collected
Personal Information Statement
  • By completing this application, you are requesting the faculty to consider you for any in-course award that you may be eligible to receive.  Applicants need not indicate which award they would like to be considered, since the faculty will determine this based on the award application and the area of nursing interest of the applicants. Please note that many of these awards have residency and financial need requirements. We encourage all eligible applicants to complete the award application form.

    APPLICATION DEADLINE: May 8, 2019


    The due date for this form has expired. If you have any questions, you can contact awards.nursing@utoronto.ca.

  • The following data is collected on this form:

    Academic Year (system provided field)

    Date and Time of form submission (system provided field)

    For the next three questions, if you select No, you will not be able to continue with the application and you can discuss your options by contacting awards.nursing@utoronto.ca

    Personal Information Collection Consent. See tab (No, or Yes, I agree with the statement)

    Agree to transcripts access by those who need to know (No, or Yes, I agree with the statement)

    If you are selected for an award, professional/academic highlights (not financial data) may be provided to the award donor. In submitting the application, you agree to this disclosure (No, or Yes, I agree with the statement)

    PERSONAL INFORMATION

    Student Number  

    First Name/Given Name

    Last Name/Surname

    Preferred Name

    Street Address

    Apartment #

    City

    Province

    Postal Code

    Email & Email Confirmation

    Phone Number

    PROGRAM INFORMATION

    Degree (drop down selection list):

    MN: Clinical
    MN: HSLA
    MN: NP
    PhD
    Post Master

    Current Year of Study (academic year 2018-2019) (drop down selection list)

    RESIDENCY

    Residency and financial information is being collected to confirm eligibility for OSOTF and OSOTF II/OTSS awards, which are given based on financial need and residency requirements. International students are not eligible; however, they are eligible for other awards. Please note that many awards are based on need and residency.

    Status in Canada (drop down selection list):

    Canadian Citizen or Permanent Resident

    Study Permit

    Ontario Residency (drop down selection list):

    Student has always resided in Ontario

    Ontario is the last province that the student has resided in for 12 consecutive months without being a full-time postsecondary student

    Students considered married or in a common-law relationship for OSAP purposes may be considered Ontario residents if the student’s partner/spouse has resided in Ontario for at least 12 consecutive months immediately before the last day of the month in which classes began for the student’s most recent period of full-time post-secondary studies and during this time, the student’s partner/spouse was not enrolled in the full-time post secondary studies

    Student currently resides in Ontario and has lived in Canada fewer than 12 months in a row

    None of the above apply, student is not a resident of Ontario

    ACADEMIC AND PROFESSIONAL BACKGROUND

    For PhD Applicants – Have you worked as a RN for at least 5 years or full time equivalent? (Yes, No)

    For MN and Post-Mater Applicants – Have you worked as an RN for at least 3 years or full time equivalent? (Yes, No)

    If worked as an RN – How many years have you worked full-time as a RN?

    Nursing Interest.  Please indicate up to 3 nursing interests from the following list. The list is based on awards available for specific areas of nursing and is not a comprehensive list of all nursing interest areas. There are also several awards available that are not based on a specific area of interest.

    Aboriginal Health Nursing
    Addictions
    Cardiac/ Stroke
    Community Health
    Geriatric
    Global Health
    Health Policy/ Nursing Administration
    Hospice and Palliative Care
    Maternal Health
    Medical/Surgical Nursing
    Mental Health Nursing
    Neurosciences
    Nursing Education
    Oncology
    Paediatrics
    Pain Management
    Preventive Care
    Rehabilitation Nursing
    Public Health
    Women/Gender Health
    Veterans

    Please provide a brief statement that summarizes your academic background and professional experience.

    Please elaborate on your nursing practice/ research interests, as well as leadership and/ or extracurricular activities during the Nursing program.

    Please describe your career goals and how your program of study helps you achieve these goals.

    BUDGET

    If the applicant chooses not to complete the financial budget or fails to demonstrate need, the applicant will be considered for non-need-based awards only.

    For PhD program – Please enter total 12-month budget from September 1, 2019 to August 30, 2020.  Please provide information about the resources and expenses you anticipate between September 1, 2019 and August 31, 2020. Tuition, books and supplies will be considered when the application is reviewed. Do not enter them on the form. Please do not use weekly or monthly figures.

    For MN or Post-MN programs – Please enter your 10-month budget from September 1, 2019 to June 30, 2020 Please provide information about the resources and expenses you anticipate between September 1, 2019 and June 30, 2020. Tuition, books and supplies will be considered when the application is reviewed. Do not enter them on the form. Please do not use weekly or monthly figures.

    Are you expecting to work part-time during the academic year (2019-2020)? (Yes, No)

    If Expecting to work – Number of Hours per Week.

    If Expecting to work – Resources – After-tax deduction employment income. Please enter the after tax employment income you will, or expect to receive in 2019-2020.

    Resources – Awards. Please enter the Awards/Scholarships/Fellowships you will, or expect to receive in 2019-2020.

    Resources – OSAP or other government student aid.  For applicants who are eligible to apply for OSAP: If you did not receive OSAP this year and are planning to apply for the upcoming academic year, enter the amount from the online OSAP Aid Estimator. https://osap.gov.on.ca/AidEstimator1819Web/enterapp/enter.xhtml?lang=en

    Resources – Other After-tax deduction Income (all sources).  Enter an estimate of all other gross taxable and non-taxable income which you expect to receive (except employment income), such as income from dividends, etc. during the period in 2019-2020. 

    Resources – Family Support/Spousal Contributions. Please enter the family support/ spousal contribution you will, or expect to receive during the period in 2019-2020.

    Resources – Spouse/Partner Income (after-tax).

    Resources – Savings/RESP. Only include the total amount of savings you currently have access to (i.e. money that you could withdraw today that is not locked into an investment). Include any RESP funds that you expect to withdraw to fund your education for the upcoming year.

    Resources – RSPs 

    Resources – Other

    If  “Resources- Other” is greater than zero, provide details

    Total Resources (system calculated field)

    Expenses – Rent/Mortgage.  For PhD students, please enter only the expense of rent/ mortgage payments you are responsible for during the 12-month period in 2019-2020. For MN and Post-Master students, please enter only the portion of rent/ mortgage payments you are responsible for the 10-month period in 2019-2020.

    Expenses – Utilities.  Please enter only the expense for utilities you are responsible for the period in 2019-2020. 

    Expenses – Food & Household Supplies.  Please enter only the expense for food and household supplies you are responsible for the period in 2019-2020. 

    Expenses – Transportation.  Please enter only the expense for transportation you will, or expect will be during the period in 2019-2020.

    Expenses – Telephone/Internet.  Please enter only the expense for telephone/ internet you are responsible for the period in 2019-2020. 

    Expenses – Child/ Dependent Care.  Please enter only the expense child/ dependent care you are responsible for the period in 2019-2020. 

    Expenses – Other.  Include other necessary expenses you expect to incur.

    If  “Expenses- Other” is greater than zero, provide details

    Total Expenses (system calculated field)

    Additional Information (e.g.exceptional circumstances for need-based award).  Please describe any exceptional circumstances that may not be evident in the budget section. Please provide a brief statement that you would like the Committee to consider.

    CERTIFICATION I certify that all the information provided on this application is, to the best of my knowledge, truthful, accurate and complete.

    For PhD applicants – Confirm Certification Statement and the budget information entered above is for the entire period from September 1, 2019 to August 31, 2020. (Yes, No)

    For MN and Post-Master applicants – Confirm Certification Statement and the budget information entered above is for the entire period from September 1, 2019 to June 30, 2020. (Yes, No)


    Other Data Collected 

    This data is automatically collected by the system for the purpose of Information Technology administration and trouble shooting, as may be required and for summary-level only website statistical reporting:

    Browser Type

    Browser Version

    IP Address (does not identify you)

    Hardware and operating system (reported on an aggregate level)

    Country/City of data origin (reported on an aggregate level)

    Session duration (reported on an aggregate level)

  • The University of Toronto respects your privacy. The information on this form is collected pursuant to section 2(14) of the University of Toronto Act, 1971. It is collected for the purpose of administering admission, registration, academic programs, university-related student activities, activities of student societies, financial assistance and awards, graduation and university advancement, and for the purpose of statistical reporting to government agencies. Your IP address and browser version are collected for Information Technology troubleshooting, as may be required. At all times, all data is 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’s Freedom of Information and Protection of Privacy Office at 416 946-5835, Room 104, McMurrich Bldg., 12 Queen’s Park Crescent West, Toronto, ON, M5S 1A8.

    I agree to have the information in this form plus my IP address and browser version be collected and stored electronically and I understand it will be protected in accordance with the Freedom of Information and Protection of Privacy Act. I understand that the information will be shared and viewed only by those who need to know. I also understand this form will be retained based on the University’s best practice guidelines for records retention, after which it will be destroyed in accordance with Information Technology Security best practices.

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