Funding Request Form - UVIC Society for Students with a Disability

SSD Funding Request Policy Application Form

This is the foundation for a funding application, though both itemized receipts or items quotes AND documentation from a registered medical professional must be included.

Date
Date Format: MM slash DD slash YYYY
Name*
UVic V-number*
Email*
Phone
As of this semester, are you taking for-credit classes with the University of Victoria? (y/n)*
Have you received funding through the SSD before?*
If you answered "Yes" to the previous question, when was that funding application full-filled?
Funding Request Category*
Funding Request Category Number*
Name of item(s) being requested*
If applicable, required specs on requested technology*
*Specialized specs may include larger screen size or increased computer memory or capacity to run specific software to course-work and disability accommodation simultaneously.
Quoted amount for requested item(s)
Drop files here or

Accepted file types: txt, rtf, jpg, bmp, gif, webp, png, pdf, doc, docx.
Please explain the relevance of the requested item(s) to your reducing your barriers, because of your disability(ies), to participate in your studies with the University of Victoria:*
Please upload relevant documentation from a registered medical professional:
Drop files here or

Accepted file types: txt, rtf, jpg, bmp, gif, webp, png, pdf, doc, docx.
Ensure that the registered medical professional notes that the *specific* item(s) you have requested are needed for you because of and pertaining to your disability(ies).
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SSD Funding Request Policy Application Form

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