Post Secondary Education Assistance:




    ** According to the policy manual, students who misrepresent their depent or academic status will have their funding terminated**
    In the event that you cannot be reached at your resident, leave your name and number where a message may be left for you.

    Next of Kin:

    Address - Next of Kin:

    Previous Education and Training:

    Statement of your Education Goals

    Are you funded fully or partially by another source such as First Band / Agency / Tribal Council / or any other post-secondary source? (scholarships, bursaries and loans are not included)
    If Yes Where is the funding assistance coming from

    Institute choice where funding is required

    I certify that all the above information I have provided on this application is correct and completed and that no relevant information has been withheld or falsified. I understand that misrepresentation, falsification of documents, or withholding of requested information in regard to this application may result in a immediate cancellation of my application. I also agree to abide by the policies set out by the Red Pheasant Education Authority in regards to post-secondary students.

    I verify that I have received a copy of the current policy manual.

    Privacy Act Statement
    The information you provide on this document is for the purpose of resource and administering post-secondary financial assistance. Personal information that you provide is protected under the provision of the PRIVACY ACT.

    I hereby authorize that all information concerning my academics may be released upon request to Red Pheasant Past Secondary:
    1. Pertaining to my program / course registration
    2. Pertaining to my financial obligations
    3. Pertaining to my attendance
    4. Pertaining to my academic progress and / or related information

    By Submiting this document I agree to all terms of this document.