KPMG's 2012-2013 Aboriginal Scholarship Application - Algonquin ...

KPMG’s 2012/2013
Aboriginal
Scholarship
We’re proud to provide
five $1,500 scholarships in
support of Aboriginal students
Deadline: August 2, 2012
Apply Today!
kpmg.ca/aboriginalservices
© 2012 KPMG LLP, a Canadian limited liability partnership and a member firm of the KPMG network of independent member firms
affiliated with KPMG International Cooperative (“KPMG International”), a Swiss entity. All rights reserved. 6863

KPMG’s FIRST NATIONS AND ABORIGINAL STUDENT AWARDS APPLICATION
KPMG is committed to building successful relationships with Canada’s First Nation and Aboriginal Communities
through our Aboriginal Client Services practice – a dedicated group of professional advisors serving the needs of
First Nations and Aboriginal clients across Canada.
KPMG’s First Nations and Aboriginal Student Awards Program is available to encourage and assist First
Nations and Aboriginal students in the pursuit of post-secondary education in the fields of Business or First
Nation Financial Administration. KPMG is providing five student awards of
$1,500 CDN each.
To be eligible you must be:
• A Canadian citizen
• A Status Indian, non-status Indian, Inuit, Innu or Métis
• A full-time student who is currently enrolled in, or has
been accepted to, a university or community college
• Pursuing studies of Business or First Nation Financial
Administration
Applications must be received by August 2, 2012 for the
2012/2013 academic year. Complete and return to:
Penny Eggett, National Marketing Coordinator
KPMG MSLP
Bay Adelaide Centre
333 Bay Street
Toronto, ON M5H 2S5
GENERAL INFORMATION
Name:
Permanent Address:
Street City/Town Province Postal Code
Current Address:
(if different from above) Street City/Town Province Postal Code
Current Address from:
(date)
Telephone: Day ( ) Evening ( ) Canadian Resident? ❑ Yes ❑No
Canadian Citizen? ❑ Yes ❑No
to
I am a: Status Indian Non-Status Indian Inuit Métis Innu
(date)
EDUCATION (Please complete the following, starting with the most recent institution attended.)
Names of College/University and/or
Major Length of Program
vocational institution attending/attended
(# of years)
Name of the
Diploma/Degree Certificate
Program enrolled in
Currently in
which year
Year expected to
graduate or year
obtained
(month/year)
Indicate your overall grade point average (GPA) to date for the 2011/2012 academic year
of _______
(Attach a copy of your transcript) GPA Max GPA
Indicate your overall grade point average for your previous academic year
(Attach a copy of your transcript) GPA Max GPA
of

EXTRA-CURRICULAR ACTIVITIES/INTERESTS/COMMUNITY INVOLVEMENT (please describe your
extra-curricular activities including class/school activities, volunteer experience, community involvement, memberships, sports
activities, hobbies, etc. Attach additional comments if space is insufficient.)
WORK EXPERIENCE: (IF APPLICABLE) (Beginning with your current or most recent employer, please describe
full-time/part-time/summer/internship experience. Attach additional comments if space is insufficient.)
Name of Employer Type of Business Your Job Title Employed
From:
To:
FINANCIAL RESOURCES (Please list all other awards and scholarships you have been awarded. Attach additional
information if space insufficient.)
Award Name Amount Period to which it applies (please indicate multiyear award)
Please complete the following list of resources for the upcoming academic year (2012/2013):
Parental/Spousal contribution $
Contribution from other family/friends $
Scholarships/awards (total from above) $
Accumulated personal savings $
Expected employment/other income $
Other (please specify) $
TOTAL $
Please attach a budget of expenditures for your upcoming scholastic year:
Tuition $
Books $
Other fees $
Accommodations:
- residence fee
- meal plan
- rent
- utilities
- other (specify)
Travel costs (provide details) $
Other (please specify):
$
$
$
$
$
TOTAL EXPECTED EXPENDIDTURES $
$
$
$
$
$

SINGLE APPLICANTS
Parents’ Combined
2011 income
Number Dependent Children (including
yourself) in family
Number dependent children attending post-secondary studies in
fall (including yourself)
• Less than $25,000 1 1
• $25,000 - $40,000 2 2
• $40,000 - $60,000 3 3
• $60,000 - $80,000 4 4
• $80,000 - $100,000 5 5
• $100,000 + 6+ 6+
MARRIED APPLICANTS
Spouse’s
2011 income
Number Dependent Children (including
yourself) in family
Number dependent children attending post-secondary studies in
fall (including yourself)
• Less than $25,000 1 1
• $25,000 - $40,000 2 2
• $40,000 - $60,000 3 3
• $60,000 - $80,000 4 4
• $80,000 - $100,000 5 5
• $100,000 + 6+ 6+
ABOUT YOU (Use this space to tell us about what you seek to achieve for yourself and your community, the kind of work
you want to pursue after graduating, your longer term career goals, how you chose the educational institution and program you are
pursuing and why you believe you should be selected by KPMG’s Aboriginal Client Services group to receive a First Nations and
Aboriginal Student Award. Attach additional comments if space is insufficient)
If you are selected for one of KPMG’s First Nations and Aboriginal Student Awards, how do you plan to use the award? (attach
additional comments if space is insufficient)
The information I have provided in my application is true and complete.
I, the undersigned, hereby acknowledge that the student award will be a taxable receipt and I hereby provide my social insurance
number (or band registration number) for the purposes of being issued a T4A information slip, to be received early in 2013. I
acknowledge that it is my responsibility to properly report the income in my personal income tax return for 2012.
I further acknowledge that the award will be made payable jointly to myself and the post-secondary institution. The institution will
be directed to apply the funds to unpaid tuition and ancillary fees. Amounts in excess of any unpaid amounts will be paid to the
award recipient by the institution to use for housing, transportation, books, etc.
________________________ ________________________________ ________________________
Signature Name (please print) Date
Please note, applications received without the properly signed acknowledgement will not be processed.
See website at kpmg.ca/aboriginalservices for selection criteria details and requirements of the winners.