JUS557 Form

LEGAL STUDIES FOR ABORIGINAL PEOPLE (LSAP) PROGRAM

Appraisal Form 2006 -

ACCÈS AUX ÉTUDES EN DROIT POUR LES AUTOCHTONES (AEDA)

Formulaire d'évaluation 2006

BURSARY INFORMATION
Aboriginal Ancestry	Academic Year	Have you recieved a LSAP bursary
Métis Non-Status Indian	1st year 2nd year 3rd year	No Yes if yes, for what year(s)
PERSONAL INFORMATION (if you address changes, you must notify the Department of Justice Program )

Mr. Ms. Mrs. Miss	Last Name	Given Name(s)	Date of Birth
Marital Status
Single Married/common-law or sex realashioship	Divorced Seprated Widowed Number of children that you and your partner support (if applicable)
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:

CONTACT INFORMATION (if we cannot reach you otherwise for a post-graduation survey)

Name and relation of Contact:

Address of Contact if different from your permanent address:			Home Telephone No.	Office Telephone No.	Fax No.
			Email Address:

ACADEMIC INFORMATION
Describe all your post-secondary studies to date
(Complete the section below and include your statement of marks for all post-secondary studies)
Subject/Type of Program	Name of Academic/ Training Institution	Date Completed	Diploma/Degree Received Yes No

APPRAISALS FORMS

It is your responsibility to supply your appraisers with a copy of the appraisal form that can be found with this application. Appraisal forms should be from individuals who are associated with the last academic or training institution in which you were enrolled or, if you did not attend an educational institution in the previous three years, then from someone who knows your work or studies. Completed appraisal forms are to be submitted to the Department of Justice by your appraiser before the application deadline of June 15.

FIRST TIME APPLICANTS ONLY
List the law schools to which you have applied Indicate whether you have received conditional or unconditional acceptance. (if available, please include a copy of the law school acceptance letter(s).)
Name of School	Conditional Acceptance	Unconditional Acceptance	Application Date

(2006/01) Ce formulaire est aussi disponible en français

JUS 557e.pdf

FINANCIAL INFORMATION (January 1st to December 31st)
Income (estimated amounts acceptable)	Amount from Previous Year	Amount in Current Year	For Office use only
1. Employment
Full-time
Part-time
Teaching assistanship
Other (please explain)
2. Other revenues
Employment Insurance
Disability Insurance
Severance Pay
Child Support
Other (please explain)
3. Financial Assistance from:
Parents
Spouse/common-law same sex partner
Other relatives
4. LSAP:
Previous year
Other scholarships
5. Student Loan
6. Native Post-Secondary Student Support Program
7. Canadian Pension Plan
Orphan benefits
Disability benefits
Survivor benefits
Other (please explain)
8. Other income (please explain):
	SUB-TOTAL

Expenses(estimated amounts acceptable)	Current Year	For Office
1. Tuition and compulsory fees
2. Books and school supplies
3. Living costs
Food
Shelter (rent or mortgage)
Local transportation (car, bus)
Electricity, heat, cable, telephone
4. Child Support
5. Other financial obligations (please explain):
SUB-TOTAL
TOTAL
TOTAL = INCOME - EXPENSES SURPLUS (if your income is greater than your expenses (+)) DEFICIT (if your expenses are greater that your income (-))
JUS 557e, p. 2 (2006/01)

A 750 WORD ESSAY
1st Time Applicants	First time applicants must include an essay (approximately 750 words in length) describing their reasons for pursuing legal studies and career goals. Your essay must include Reasons for pursuing law studies Career goals Significant accomplishments related to your interest in law (e.g. awards, participation in the community, etc.) Extra-Curricular/Work Activities Special challenges (if applicable) faced that have led you to want to pursue law school
Bursary Renewal	Applicants applying for bursary renewal must include an essay (approximately 750 words in lenght) describing experiences in the previous academic year. Your essay must include: Challenges faced Special accomplishments Extra-curricular or other experiences Career goals
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.
DECLARATION
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 required information and documents by June 15th . 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 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. ___________________________________ ____________________________ Signature Date Please note that only applications with an original signature will be acceptedPresent and former governmental employees should contact the Program to obtain a Conflict of Interest Form(They may be obtained at this address: http://www.tbs-sct.gc.ca/pubs_pol/hrpubs/tb_851/siglist_e.asp)

MAILING ADDRESS
The Legal Studies for Aboriginal People Program Department of Justice Canada Programs Branch 284 Wellington Street, EMB, 6th Floor Ottawa, Ontario KlA OH8	Toll-free Local E-mail Web address	1-888-606-5111 (613) 941-0388 lsap06@justice.gc.ca www.canada.justice.gc.ca
BURSARY CHECKLIST
Applicants must ensure that the following information is post marked to the Department of Justice no later than June 15 of the application year to be considered for a bursary A Application Form B Declaration C Acceptance Letters (This is only applicable to first time applicants) D Appraisal Forms E Official Transcript F A750 Word Essay Did I include an essay? Is my name on each page? Does my essay include each point requested in the application?

1st Time Applicants

First time applicants must include an essay (approximately 750 words in length) describing their reasons for pursuing legal studies and career goals. Your essay must include

Reasons for pursuing law studies
Career goals
Significant accomplishments related to your interest in law (e.g. awards, participation in the community, etc.)
Extra-Curricular/Work Activities
Special challenges (if applicable) faced that have led you to want to pursue law school

Bursary Renewal

Applicants applying for bursary renewal must include an essay (approximately 750 words in lenght) describing experiences in the previous academic year. Your essay must include:

Challenges faced
Special accomplishments
Extra-curricular or other experiences
Career goals

JUS 557e, p. 4 (2006/01)