Post Secondary Application

KEY FIRST NATION
POST SECONDARY EDUCATION
P.O. BOX 70
NORQUAY, SK. S0A 2V0
TEL: (306) 594-2020
FAX: (306) 594-2545
WWW.KEYBAND.COM

POST SECONDARY EDUCATIONAL ASSISTANCE
NEW APPLICATION
PROTECTED WHEN COMPLETED
"PLEASE PRINT CLEARLY"
PLEASE NOTE APPLICATIONS NOT COMPLETED WILL BE RETURNED,
PLEASE FILL ALL SECTIONS THAT APPLY TO YOU. THIS WILL SAVE YOU AND PSE TIME.

Post Secondary Education

Date Of Application *

Student Months Used *

Hours Of Study *

Full-time

Part-time

Academic Year *

Semester *

Student ID # *

Institution *

Address *

General Information

Full Name *

Former Name

Student Address *

Permanent Address *

Phone *

E-mail Address *

Treaty # *

Gender *

Male

Female

Other

Date Of Birth *

Marital Status *

Single

Single Parent

Married/Common Law

Is Your Spouse Employed?

Number Of Dependent Children *

Please List Your Dependent Children If Applicable

Name, Date Of Birth, Relationship

Next Of Kin *

Phone *

Previous Education And Training

Please Offer Information Regarding Your Elementary And Secondary Schooling And, As Well, Any Post Secondary Training/Education You May Have Undertaken *

School Name, Location, Year Completed

Program Completed *

Certificate/Diploma/Degree *

Level Of Education *

Elementary

Secondary

Post Secondary

Present Education Goals

Name/Address Of Post Secondary Institution You Wish To Attend *

Course Program *

Year *

Program Length *

Funding Period: Start Date *

Funding Period: End Date *

(Do only if you are a first-year student or if your goals have changed since your last
application.) Briefly describe both your short-term and long-term educational goals, indicate
clearly the importance of the course/program you wish to attend. Use separate paper and attach
to the application. Please write neatly and clearly.

Student Signature

Date

CONTRACT BETWEEN
THE STUDENT AND SPOUSE, AND
KEY FIRST NATION, POST SECONDARY EDUCATION

I UNDERSTAND THE FOLLOWING CONDITIONS FOR SPONSORSHIP BY KEY FIRST
NATION FOR POST SECONDARY STUDIES:

1. I WILL ACCEPT THE RESPONSIBI LITY TO ADH ERE TO THE SCHOOL
REGULATIONS AND MEET THE STANDARDS REQUIRED BY THE SCHOOL FOR
CONTINUTATION IN MY COURSE OF STUDIES.

2. I AGREE TO ATTEND CLASSES REGULARLY.

3. I AGREE TO CONSULT WITH A COUNSELLOR IF ANY PROBLEMS ARISE
ACEDEMICALL Y, EMOTIONALLY, PHYSICALLY AND FINANCIALLY.

4. I AGREE TO PROVIDE MY MARKS AND REPORTS ON A SEMESTER BY SEMESTER
BASIS TO THE KEY FIRST NATION AND/OR UPON KEY FIRST NATION'S REQUEST.

5. I AGREE TO REPORT ANY CHANGES TO MY STUDENT AND/OR PROGRAM
STATUS PROMPLTY. I UNDERSTAND THAT IT IS A SERIOUS MATTER TO
PROVIDE FALSE INFORMATION AND/OR FAIL TO REPORT ANY CHANGE IN THE
INFORMATION PROVIDED.

6. I AUTHORIZE THE KEY FIRST NATION DIRECTOR OF EDUCATION TO OBTAIN
INFORMATION FROM PERSONS, AGENCIES, ORGANIZATIONS OR OTHER FIRST
NATIONS TO DETERMINE AND/OR VERIFY MY ELIGIBILITY FOR BENEFITS OR
SERVICES UNDER THE POST SECONDARY STUDENT ASSISTANCE PROGRAM.

7. I DECLARE THAT ALL OF THE INFORMATION PROVIDED IS TRUE AND COMPLETE
AND I MAKE THIS SOLEMN DECLARATION BELIEIVNG IT TO BE TRUE AND
KNOWING THAT IT IS OF THE SAME FORCE AND EFFECT AS IF MADE UNDER
OATH.

8. I UNDERSTAND THAT I HAVE THE RIGHT TO APPEAL ANY DECISION MADE WITH
RESPECT TO MY APPLICATION FOR SPONORSHIP.

I HEREBY AGREE TO THE TERMS/CONDITIONS FOR FINANCIAL ASSISTANCE THAT I
HAVE READ ABOVE.

Student Signature *

Date *

Spouse Signature

Date

I HEREBY AGREE AS A SPONSOR TO PROVIDE MORAL SUPPORT AND ENCOURAGEMENT THAT MAY BE NEEDED BY THIS STUDENT TO COMPLETE HIS/HER STUDIES.

Sponsor Signature (Optional)

Date

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The Key First Nation

P.O. Box 70
Norquay Saskatchewan
Canada
S0A 2V0

Phone (306) 594-2020
Fax: (306) 594-2545