Access Program

Discover the path between you and your dreams

Launch the journey toward your dreams. When you’re accepted to the Access program, you have the support you need to forge your way to a successful academic future.

With Access, you’ll find the supportive place, people, and programs that will help you succeed.

Access Program Application Form

Application for:

REQUIREMENTS
  1. Answer all questions fully. Incomplete applications will not be considered.
  2. Complete application must include transcripts and two (2) reference forms.
  3. All information on this form is confidential and is to be used only in assessing the applicant’s eligibility/suitability for the Program.
  4. APPLICATION DEADLINE: May 1st, midnight.
  5. Contact Access if you require further information, at 204-474-8000 or toll free at 1-800-432-1960 ext. 8000
Indicate your preferred field of study:
(Examples: Arts, Science, Medicine, Dentistry, Nursing, Education, Social Work, Pharmacy, Management, Fine Arts, Law, Kinesiology, etc.)
How did you hear about the program?  
STUDENT REGISTRATION
  Last Name*:  
First (Given) Name*:
Middle Name(s):
Preferred First Name:
Date of Birth (yyyy-mm-dd)*:
Home Community:  
Home Address:
City/Town:
Province:
Postal Code:
Day Phone:
Evening Phone:
Email address*:
Emergency Contact:
  *Required information
Marital Status:   Do you have any dependants?  
Dependant's Name Age Relationship
How many of the above dependants are you supporting?  
ANCESTRY
Important: If you are Aboriginal provide a copy of your Treaty Status or Métis card. The Access Programs reserves the right to request verification of Aboriginal ancestry.
  • Upload your Treaty Status or Métis card
  • (Required file format: PDF only, not larger than 4 Megabytes.)
EDUCATION
High School
Location
Last Grade Completed
Year Received
Have you received upgrading since you left school?  
If you answered yes to the above question. was it:
Adult Basic EducationGED
Indicate level completed:
Date Completed:
Are you currently enrolled in an upgrading program?
What is the completion date?  
Have been enrolled in any post-secondary education or training programs?
(I.e. Transition Year Program, Health Career Quest Summer Camp, Urban Circle,
college, university, nursing school, New Careers, Core Area Training, other provincially funded programs, etc.)
 
Institution Program/Course Attendance Dates Did you complete?
Have you ever withdrawn, been suspended, or placed on probation from any university, college or post-secondary institution?  
If yes, please explain.
Failure to disclose your previous or current academic status (no matter how much time has elapsed) may result in the withdrawal of your application.

Enclose with your application, interim & or final transcript(s) of all your marks for high school, upgrading and post-secondary institutions you attended. If you are currently attending U of M, you can print your transcripts off Aurora Student or provide written permission allowing the Access office to print your marks off the Aurora system. (You may provide an interim transcript while waiting for your final grades.)

  • Upload your transcript(s) file
  • (Required file format: PDF only, not larger than 4 Megabytes.)
  • (All your transcripts should be in one PDF file)
EMPLOYMENT/COMMUNITY INVOLVEMENT
1. EMPLOYMENT HISTORY - Begin with your present job.
Employer Your Position Dates (DD/MM/YY) Reason for Leaving
2. VOLUNTEER/COMMUNITY INVOLVEMENT - List all volunteer experience and community involvement that you have had in the past five years.
Organizations (Name and Place) Year(s) Involved Your Function
Do you need to add additional employment history and/or volunteer/community involvement?  
You can add additional information here:

  • Upload your resume (optional)
  • (Required file format: PDF only, not larger than 2 Megabytes.)
SHORT ESSAY
The short essay is an important part of the application. Incorporate the following seven (7) topics into your short essay.

  1. How and when you became interested in your career choice
  2. Circumstances in your life that kept you from pursuing an education/career
  3. What you have done to prepare for this challenge
  4. Your present situation
  5. Your strengths and weaknesses
  6. Why you should be chosen for this program, i.e., why you think you need this program
  7. Your participation in community services

Type in the box below:

FINANCIAL INFORMATION
Are you currently: (check all that apply)

Employed full-time (30 hours/week or more)CasualEmployed SeasonallyEmployed part-timeStudentVolunteer

INCOME LEVEL:  

The financial information should be based on combined family income (that is the income, assets, expenses and debts of you and your partner).
Your application is not complete unless this section is completed accurately. This information will be used to assess your eligibility. This form will be returned to you for completion if any information is found to be missing.
Applicant Spouse
Earnings (before deductions)
Employment Insurance Benefits (gross) or Employment & Training Services
Band Sponsorship
Scholarships
Bursaries or other awards
CRISP, SAFER, WORKERS COMP, Orphans Benefits, Disability Benefits, i.e.,
Government
Child Support, Spousal Support, Settlements i.e. Divorce, MPI, etc.
Social Assistance (provincial, municipal, band).
Will this continue while you are in school?  
Are you single and living at home with parents?   Parent 1 Parent 1
What is the total income of parents

Indicate the number of dependant children in your family, including the applicant.

Do not include children who have claimed independent status (i.e. Single parents under the age of 23 or children who are working full time).

Are your tuition, books and supplies paid for by a sponsoring agency?  
Have you applied for any assistance/funding for which you have not yet received a response?  
Describe type of assistance  
Is there any other financial information which would help in assessing your need?
You may be required to apply for a Canada Student Loan as part of your financial support.

Have you ever applied for a Canada Student Loan in the past?  

What is the status of that loan?  

We encourage applicants to explore all outside funding options. Many applicants bring funding from outside sources, e.g., Study Assistance for Income Allowance
Recipients (SAIAR), scholarships, bursaries and band sponsorship. Those students with insufficient outside funding may apply to Manitoba Student Aid for supplementary funding. Please note that in order for a student to be eligible for a non-repayable Access bursary the student must be on full Canada Student Loan/Manitoba Student Loan.

REFERENCES
Two submitted reference forms from people (other than relatives) are required. The online refterence form can be found at extended.cc.umanitoba.ca/reference-form.

List their names, addresses, phone numbers, and position or organization below.
One of your references should be either a teacher or employer.
Name Address Phone Position/Organization
It is your responsibility to make sure your references are submitted in by May 1st at midnight.
DECLARATION

Applicants are advised to read all application materials carefully. Failure to disclose relevant facts (including ALL previous attendance at post-secondary institutions) and/or submissions of false information or documentation may result in acceptance and registration being withdrawn. If this information is discovered in a subsequent session, it may result in dismissal from the University. Registration at a post-secondary institution subsequent to the submission of this application must be declared in writing.

  • I hereby certify that I have read and understood the instructions and information on this application form and that all statements made in connection with this application are true
    and complete.
  • I authorize the University to verify any information, transcripts or reference letters provided as part of this application.
  • I accept that any information on falsified documents may be shared with the Association of Registrars of the Universities and Colleges of Canada.
  • I authorize my high school/university to release my academic record(s) should the need arise to accelerate the processing of this application.
  • I understand that if I am selected to the Access Programs, I am required to attend the mandatory Orientation in August before start of class.
  • I understand that if I am selected to the Access Programs, staff may be required to advocate on my behalf with the funding agency who may request personal
    information for the purpose of assessing academic or financial status. By signing this application form, I hereby authorize the University of Manitoba Access Programs
    to release personal information as required to satisfy the funding agency. The information required by the funding agency may include, but is not limited to, mid-term
    grades, final grades, registration history, course enrollment, credit hours, attendance, tuition and fee amounts, etc.
Your application will not be considered if you have not included the following:

  • Application/Access Programs
  • Transcripts (high school, post-secondary, other training programs)
  • Two completed reference forms
  • Proof of Aboriginal Ancestry, if applicable
  • Short essay
  • Financial information
  • Signed declaration
  • Application/University of Manitoba

(Note: a separate application must be submitted to U of M Admissions Office)

Notice Regarding Collection, Use, and Disclosure of Personal Information by the University
Your personal information is being collected under the authority of The University of Manitoba Act. The information you provide will be used by the University for the purpose of admission, registration, assessment of academic status, eligibility for the program, and communication with the student. Your personal information may be disclosed to other educational institutions, government departments and co-sponsoring organizations for reporting
purposes. For those students who are members of the University of Manitoba Students’ Union, your information will be disclosed to UMSU. Your personal information will not be used or disclosed for other purposes, unless permitted by The Freedom of Information and Protection of Privacy Act (FIPPA). If you have any questions about the collection of your personal information, contact the Access & Privacy Office (tel. 204-474-9462), 233 Elizabeth Dafoe Library, University of Manitoba, Winnipeg, MB, R3T 2N2.

Disclosure of Personal Information to Statistics Canada
The Federal Statistics Act provides the legal authority for Statistics Canada to obtain access to personal information held by educational institutions. The information may be used only for statistical purposes, and the confidentiality provisions of the Statistics Act prevent the information from being released in any way that would identify a student. At any time, students who do not wish to have their information used are able to ask Statistics Canada to remove their identifying information from the national database. Further information on the use of this information can be obtained from Statistics Canada’s website (statcan.gc.ca) or by writing to the Post-Secondary Section, Centre for Education Statistics, 17th Floor, R.H. Coats Building, Tunney’s Pasture, Ottawa, Ontario, Canada, K1A 0T6.

To the best of my knowledge, I certify that the information contained in this application is true and complete. I realize that any false statement contained in this application may result in my disqualification for or from this program.  (Check this box to accept)