Application FormNB Community College Bursaries for CCNB, NBCC and NBCCD students (Fall F-0300 and Winter/Spring F-0301)
Personal and Educational Information Social Insurance Number This is required for Income Tax Purposes. College Student ID Number Marital Status Common-law partner Married Single Single parent Last Name Initial First Name If you receive a bursary, what name should be on the cheque? Please keep it short. The space on the cheque (for your first name, initial and last name) is limited. Gender Male Female Specify Year of birth 1925 1926 1927 1928 1929 1930 1931 1932 1933 1934 1935 1936 1937 1938 1939 1940 1941 1942 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 Personal Email Address This is the email address The Foundation will use in cases where a bursary would need to be sent to you via Interac e-Transfer, in accordance with our bursary disbursement policy. (NOT your student email. Ex.: @mynbcc.ca, @nbbcd.ca or @monccnb.ca) IMPORTANT: If the student email address provided is incorrect and someone other than the recipient cashes the bursary, the Foundation cannot be held responsible for replacing said bursary. Bursary disbursement policy HERE. Includes: Policy, step by step, extra information and a list of Canadian qualifying banks for Interac e-Transfer Please specify your gender Confirm Personal Email Address I acknowledge that I have read the Foundation’s bursary disbursement policy currently in effect, and I understand that it is my responsibility to provide an accurate and active personal email address that will enable me to deposit in a CANADIAN Bank account capable of receiving Interac e-Transfer. Do you identify with any of the following? Indigenous (Canada) Person with Disabilities Permanent resident/Refugee status Person of color International student Canadian Citizen NB High School or Canadian adult program/GED Not applicable Bathurst High School Belleisle Regional High School Bernice MacNaughton High School Blackville School Bonar Law Memorial School Caledonia Regional High School Cambridge-Narrows Community School Campobello Island Consolidated School Canterbury High School Carleton North High School Central New Brunswick Academy Centre scolaire communautaire La fontaine Centre scolaire Samuel-de-Champlain Chipman Forest Avenue School Cité des Jeunes A.-M.-Sormany Dalhousie Regional High School École Aux quatre vents École Carrefour Beausoleil École Clément-Cormier École Étoile de l'Acadie École Grande-Rivière École L'Odyssée École Marie-Esther École Marie-Gaétane École Mathieu-Martin École Mgr-Marcel-François-Richard École Régionale de Baie-Sainte-Anne École Sainte-Anne École secondaire Népisiguit Étoile de l'Acadie Fredericton High School Fundy High School GED/Diplôme Adulte Grand Manan Community School Hampton High School Harbour View High School Harrison Trimble High School Hartland Community School Harvey High School James M. Hill Memorial High School John Caldwell School Kennebecasis Valley High School Leo Hayes High School McAdam High School Minto Memorial High School Miramichi Valley High School Moncton High School Nackawic Senior High School North & South Esk Regional School Oromocto High School Petitcodiac Regional School Polyvalente A.-J.-Savoie Polyvalente Louis-J.-Robichaud Polyvalente Louis-Mailloux Polyvalente Roland-Pépin Polyvalente Thomas-Albert Polyvalente W.-Arthur-Losier Riverview High School Rothesay High School Saint John High School Saint Mary's Academy Salisbury Regional School Simonds High School Sir James Dunn Academy Southern Victoria High School St. Malachy's Memorial High School St. Stephen High School Stanley Consolidated School Sugarloaf Senior High School Sussex Regional High School Tantramar Regional High School Tobique Valley High School Woodstock High School The N.B. High School from which you received your diploma. Choose ‘GED/Diplôme adulte’ if you received an adult diploma, GED or equivalent. High school graduation year 1935 1936 1937 1938 1939 1940 1941 1942 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 2026 Do you have dependants? Yes No Permanent Address The address where you will return after your studies and/or where you can be reached at that time. Number and Street Name Example: 1234 Mountain Rd Apartment#, suite#, etc. City/Town Province Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Northwest Territories Nova Scotia Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon Postal Code Example : E1A 3Y2 County Albert Carleton Charlotte Gloucester Kent Kings Madawaska Northumberland Queens Restigouche Saint John Sunbury Victoria Westmorland York This is only required for the N.B. province. Click here to see the map. Verify your address on CanadaPost.ca for the correct format. Please indicate the country of your passport. Afghanistan Albania Algeria Andorra Angola Antigua and Barbuda Argentina Armenia Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bhutan Bolivia (Plurinational State of) Bosnia and Herzegovina Botswana Brazil Brunei Darussalam Bulgaria Burkina Faso Burundi Cabo Verde Cambodia Cameroon Canada Central African Republic Chad Chile China Colombia Comoros Congo Congo, Democratic Republic of the Costa Rica Côte d'Ivoire Croatia Cuba Cyprus Czechia Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Eswatini Ethiopia Fiji Finland France Gabon Gambia Georgia Germany Ghana Greece Grenada Guatemala Guinea Guinea-Bissau Guyana Haiti Honduras Hungary Iceland India Indonesia Iran (Islamic Republic of) Iraq Ireland Israel Italy Jamaica Japan Jordan Kazakhstan Kenya Kiribati Korea (Democratic People's Republic of) Korea, Republic of Kuwait Kyrgyzstan Lao People's Democratic Republic Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Mauritania Mauritius Mexico Micronesia (Federated States of) Moldova, Republic of Monaco Mongolia Montenegro Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands New Zealand Nicaragua Niger Nigeria North Macedonia Norway Oman Pakistan Palau Panama Papua New Guinea Paraguay Peru Philippines Poland Portugal Qatar Romania Russian Federation Rwanda Saint Kitts and Nevis Saint Lucia Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa South Sudan Spain Sri Lanka Sudan Suriname Sweden Switzerland Syrian Arab Republic Tajikistan Tanzania, United Republic of Thailand Timor-Leste Togo Tonga Trinidad and Tobago Tunisia Türkiye Turkmenistan Tuvalu Uganda Ukraine United Arab Emirates United Kingdom of Great Britain and Northern Ireland United States of America Uruguay Uzbekistan Vanuatu Venezuela (Bolivarian Republic of) Viet Nam Yemen Zambia Zimbabwe College/Temporary Address Your temporary address during your College studies. Same as the permanent address Yes No Number and Street Name Example: 1234 Mountain Rd Apartment#, suite#, etc. City/Town Province Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Northwest Territories Nova Scotia Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon Postal Code Example : E1A 3Y2 Program of Study Information College & Campus CCNB, Bathurst CCNB, Campbellton CCNB, Dieppe CCNB, Edmundston CCNB, Péninsule acadienne NBCC, Fredericton NBCC, Miramichi NBCC, Moncton NBCC, Saint Andrews NBCC, Saint John NBCC, Woodstock NBCCD College Year 2025 - 2026 2024 - 2025 2023 - 2024 Which college year are you currently in or are about to begin? Admit Term Fall Winter Spring The admit term refers to the season in which your program of studies for the current school year started or will start. Example: The Fall term includes the program of studies where class starts in September or shortly after. The Winter term includes programs of studies where the first day of the school year is in January or shortly after and Spring Term includes programs of studies where the first day of the school year is in April or shortly after. Year of Study 1st 2nd 3rd Are you currently or about to start your 1st, 2nd or 3rd year of study, in your current program of study? Program of Study Other program of study Member of an Atlantic Canada Credit Union Not a member Credit Union Blackville Credit Union Burnt Church Credit Union Centreville Credit Union Dalhousie Credit Union Fredericton Credit Union Fredericton Junction Credit Union Hampton Credit Union McAdam Credit Union Miramichi Credit Union Moncton Credit Union Oromocto Credit Union Petitcodiac Credit Union Port Elgin Credit Union Rexton Credit Union Riverview Credit Union Rothersay Credit Union Saint John Credit Union Salisbury Credit Union St George Credit Union St. Stephen Credit Union Stanley Credit Union Sussex Credit Union Woodstock Next Save and Return later