Declaration I hereby certify that the information provided on this application is, to the best of my knowledge, true and complete. I understand I may be required to supply documentation, specifically my tax return (or spouse's, if applicable), for the previous year, if this application is successful and if I am requested to do so. _____________________________ __________________________ Signature of applicant Date Budget Outline: Please provide an estimated summary for the twelve-month period for which funding is being requested (e.g., September 1, 2015 to August 31, 2016). Make notes wherever explanation is useful. Period from: to 1Include expenses for your spouse/partner, if applicable. 2If your graduate department provides a guaranteed stipend (i.e., PhD funding package), you should include that amount as a resource in your budget. Please note that the needs-assessment we perform may be used either to locate particular sources of funding for that stipend, and/or to augment the total amount of funding you will receive. Resources: Amount Expenses1 : Amount Awards (specify) Fees Student Stipend/ Books & Academic supplies Research Assistantship2 Teaching Assistantship Rent/Mortgage & Utilities Other income Food & Household supplies Income of spouse/partner Transportation Less Tax Child care
Declaration I hereby certify that the information provided on this application is, to the best of my knowledge, true and complete. I understand I may be required to supply documentation, specifically my tax return (or spouse's, if applicable), for the previous year, if this application is successful and if I am requested to do so. _____________________________ Signature of applicant __________________________ Date Budget Outline: Please provide an estimated summary for the twelve-month period for which funding is being requested (e.g., September 1, 2015 to August 31, 2016). Make notes wherever explanation is useful. Period from: to 1Include expenses for your spouse/partner, if applicable. 2If your graduate department provides a guaranteed stipend (i.e., PhD funding package), you should include that amount as a resource in your budget. Please note that the needs-assessment we perform may be used either to locate particular sources of funding for that stipend, and/or to augment the total amount of funding you will receive. Resources: Amount Expenses1 : Amount Awards (specify) Fees Student Stipend/ Research Assistantship2 Books & Academic supplies Teaching Assistantship Rent/Mortgage & Utilities Other income Food & Household supplies Income of spouse/partner Transportation Less Tax Child care
OSOTF%20AND%20OTSS%20Needs%20Assessment%20Form.docx