JUS557 Form

	LEGAL STUDIES FOR ABORIGINAL PEOPLE (LSAP) PROGRAM	ACCÈS AUX ÉTUDES EN DROIT POUR LES AUTOCHTONES (AEDA)
	PRE-LAW PROGRAM APPLICATION FORM - 2008	PROGRAMME DE PRÉ-DROIT FORMULAIRE DE DEMANDE 2008
	Deadline for Application: May 15	Date limite de la demande : 15 mai

BURSARY INFORMATION AND PERSONAL INFORMATION (if you address changes, you must notify the Department of Justice Programs Branch)
Aboriginal Ancestry Métis Non-Status Indian	Mr. Ms. Mrs. Miss	Last Name	Given Name(s)
Marital Status Single Married Common-law Same sex realashioship Divorced Seprated Widowed
Number of children that you and your partner support(if applicable)	Age of the children
Please indicate where you would like to you mail to be sent Permanent Address Temporary Address

Permanent Address:	Home Telephone No.	Office Telephone No.	Fax No.
	Email Address:
Temporary Address:	Home Telephone No.	Office Telephone No.	Fax No.
	Email Address:

FINANCIAL INFORMATION FOR PRE-LAW PROGRAM (MAY TO JULY INCLUSIVE)
Income (May to July)	May to July	For Office use only
Employment, benefits
Financial contribution from parents/spouse or other for living costs and studies
Scholarships, bursaries
Canada Pension Plan Benefits (disability, survivor, orphan)
Other income (please explain)
TOTAL INCOME

Expenses (May to July)	Current Year	For Office Use Only
Tuition fees (including required case books
Books and supplies
Living costs (shelter, utilities, food, local transportation)
TOTAL EXPENSES
TOTAL = INCOME - EXPENSES

T4A - CANADA REVENUE AGENCY

If you receive a bursary, the Department of Justice Canada will issue a T4A for income tax purposes in the amount awarded.

COLLECTION AND USE OF PERSONAL INFORMATION

The Department of Justice uses relevant personal information to administer the LSAP program and to determine each applicant's eligibility. The Department collects and uses the information under the Justice Partnership and Innovation Fund criteria and Treasury Board Guidelines.

FINAL ASSESSMENT

If I receive a bursary, I agree that my final assessment will be provided to the Department of Justice Canada by the university as proof of my participation in the pre-law program.

DECLARATION AND CONSENT

I understand and have given complete and true information on this form and accompanying
attachments.
I understand that I am responsible for providing the Department of Justice with all the required
information and documents.
I understand that information I provide may be verified.
I understand that any changes to information I have provided will result in re-assessment.
I understand that I must submit any changes (such as change of address, employment etc.) promptly to the Department of Justice.
I understand that I will be required to submit a copy of the letter of offer into the pre-law program, and as such, I have included a copy of the letter of offer from the university and a copy of my acceptance.
I will inform the Department should I receive a bursary from another program for the pre-law program and my bursary will be adjusted accordingly.
I agree that my final assessment will be provided to the Department of Justice Canada.
I have read and understood this section and my signature attests to my consent to the indirect collection and disclosure of my personal information for statistical and evaluation purposes only.
I attest being an Aboriginal person (Métis or Non-Status).

___________________________________ ____________________________
Signature Date

Please note that only signed and dated applications will be accepted. For the pre-law program only, your application can be sent using registered mail or by fax at 613-941-2269.

LAW PROGRAM (September-April)
Please note that the Legal Studies for Aboriginal People Program (LSAP) Law Program application must be used if you apply for a bursary for the law program starting in September. You will find the complete
application and our guide on our website at http://canada.justice.gc.ca/eng/pi/pb-dgp/prog/legal_sap.html

MAILING ADDRESS
The Legal Studies for Aboriginal People Program Department of Justice Canada Programs Branch 284 Wellington Street, 6th Floor Ottawa, Ontario KlA OH8	Toll-free Local Fax E-mail Web address	1-888-606-5111 (613) 941-0388 (613) 941-2269 lsap08@justice.gc.ca www.canada.justice.gc.ca

JUS 738e, p. 2 (2008/02)