Dr. Gautham Kolluri Endowed Bursary Application Form

Important note: This form is not to be used by York University undergraduate or graduate students. This form is only for York University School of Continuing Studies students.

Dr. Gautham Kolluri Endowed Bursary

Student Number:(Required)

Student Name:(Required)

First Last

Student Email Address:(Required)

Enter Email Confirm Email

Please indicate whether you are an international or domestic student:(Required)

When is the start of your program?(Required)

Based on your program start date, you are not eligible to apply for the bursary currently. Please come back and complete the application in February.

Program Name(Required)

Please enter your personal statement outlining the nature of your financial need. (Max 1500 characters)(Required)

It is important to note that the Awards Committee will give preference to students whose financial circumstances unexpectedly changed after registering into the program.

Submit one (1) piece of supporting documentation demonstrating your financial need for the bursary.(Required)

Please do not submit any documents which contain sensitive personal information, such as Social Insurance Numbers (SIN), financial account/credit card numbers, Passport/Visa numbers, and Health Insurance numbers/information, etc. Only provide documents that are directly relevant to your application.

For Example, Do Not Upload:

Government Tax Documents
Documents containing a Social Insurance Number
Government IDs (Passports, Visas, Health Cards)
Private Medical Information

with the exception of doctor’s notes to the school, death certificates, etc. which are acceptable.

Check from the list below which document you are submitting.

Bank/financial statement (ensure you firstly redact any personal/unnecessary information such as your bank account details)

Proof of financial loan or OSAP

Proof of loss of employment

Physician’s statement confirming hardship due to medical reasons

Other documentation confirming extenuating financial circumstances

Attachments(Required)

Drop files here or

Max. file size: 10 MB, Max. files: 8.

Declaration:(Required)

I have provided a full and accurate account of my situation. I recognize that it is my responsibility to include relevant documentation. By uploading any documents on this form, I acknowledge and accept that I do so at my own risk. I understand that these documents should not contain specific sensitive personal information in accordance with the guidelines provided above.

Acknowledgement:(Required)

I understand the decisions of the committee are final and cannot be appealed.