Application form (text version)

Please ensure that you have included all the required documents, and completed and signed the application form. Failure to include all of the required information may result in your application not being considered.

Section A: Contact information

• Name: (First/Middle/Last)
• Date of Birth: (Year/Month/Day)
• Email Address
• Telephone Number
• Mailing Address
• Apt./Unit No
• Town/City
• Province/Territory
• Postal code

Section B: Student profile

What is your residency status in Canada?

• Canadian Citizen
• Permanent Resident of Canada
• Protected Person

Are you currently employed by Library and Archives Canada?

• Yes
• No

Note: Library and Archives Canada employees may apply if they meet the eligibility criteria.

The main goal of this bursary is to support greater equity, diversity and inclusion in Canada’s documentary heritage community by encouraging the participation of Persons with Disabilities, Members of Visible Minorities and Indigenous Peoples (First Nations, Inuit or Métis Nation). To this end, please select the group(s) that you identify with:

• Persons with Disabilities
  The UN Convention on the Rights of Persons with Disabilities describes persons with disabilities as “those who have long-term physical, mental, intellectual or sensory impairments which in interaction with various barriers may hinder their full and effective participation in society on an equal basis with others.”
• Members of Visible Minorities
  A member of a visible minority in Canada is someone (other than an Indigenous person) who is non-Caucasian in race or non-white in colour, regardless of place of birth.
• Indigenous Peoples
  Indigenous peoples are members of First Nations, Inuit, and members of the Métis Nation. Members of a First Nation include status, treaty and registered Indians, as well as non-status and non-registered Indians.

Optional: For Persons with Disabilities, if you wish to provide further details, please select the box(es) that apply to you:

• Blindness or visual impairment (unable to see or difficulty seeing)
• Speech impairment, including mutism (unable to speak or difficulty speaking and being understood)
• Deafness or hearing impairment (unable to hear or difficulty hearing)
• Mobility (difficulty moving around, for example, from one office to another or up and down stairs)
• Coordination or dexterity (difficulty using hands or arms, for example, grasping or handling a stapler or using a keyboard)
• Other disability (including: learning disabilities, developmental disabilities and all other types of disabilities)

Optional: If you have a disability that is not listed above, please specify: _________

Optional: For Visible Minorities and Indigenous Peoples, if you wish to provide further details, please specify the group(s) with which you identify:

• First Nations
• Inuit
• Métis Nation
• Black
• Chinese
• Filipino
• Japanese
• Korean
• Non-White Latin American (including: Indigenous persons from Central and South America)
• Non-White West Asian, North African or Arab (including: Egyptian; Libyan; Lebanese; Iranian)
• Person of Mixed Origin (with one parent being a member of one of a visible minority)
• South Asian / East Indian (including: Indian from India; Bangladeshi; Pakistani; East Indian from Guyana, Trinidad, East Africa)
• Southeast Asian (including: Burmese; Cambodian; Laotian; Thai; Vietnamese)
• Other (please specify): ________

Source: Employment Equity Act

Section C: Educational information

1.Name of postsecondary institution at which you are enrolled: _____________

• City
• Province

2.Name of educational program:

3. Academic level in September 2024

• 1st year college
• 2nd year college
• 3rd year college
• Undergraduate (1st year)
• Undergraduate (2nd year)
• Undergraduate (3rd year)
• Undergraduate (4th year)
• Master's degree
• Phd

4. In 2024–2025, your enrolment will be:

• Part-time
• Full-time

5. What drew you to this field of study? What inspires and excites you about the profession? (500 words or less)

6. What do you think you bring to the profession? (500 words or less)

7. Give a brief explanation of your proposed course of study and futurework objectives. (500 words or less)

Note: Applicants will be evaluated on their ability to think analytically, exercise independent judgement and to present ideas clearly.

Section D: Attachments

Please ensure that you have also included copies of the following documents:

• Proof of status as Canadian citizen, permanent resident or protected person (Please do not send originals)
• Proof of enrollment at postsecondary institution

Note: Successful applicants will be asked to provide proof of tuition payment, banking information and their Social Insurance Number prior to receiving the funds. Please do not send this information unless you are selected as a successful applicant.

Section E: Privacy statement

Please read and acknowledge consent below.

The Privacy Notice serves to notify directly individuals whose personal information is collected regarding the purpose and authority of the collection. It also serves to provide information about uses or disclosures to ensure that they are consistent with the original purpose and the right of access, pursuant to the Privacy Act. The collection, use and disclosure of your personal information is required for your participation in the Price McIntosh Bursary and authorized by program-specific legislation. Library and Archives Canada (LAC) will collect, use, disclose and protect your personal information in accordance with the Privacy Act for the purposes associated with the Price McIntosh Bursary and will use it only in conjunction with those purposes. For example, LAC will use your information to verify eligibility, evaluate applications, issue payments, and support future outreach and awareness strategies. Information may be disclosed without your consent, pursuant to subsection 8(2) of the Privacy Act – for instance, LAC may share your information with a third party, to support the payment of the bursary.

Recipients consent to the disclosure of their name, program of study and educational institution in LAC’s bursary announcements. Should you decide not to provide the personal information requested, LAC will not be able to accept your application. The personal information collected under this initiative is referenced in Personal Information Bank ‘Price McIntosh Bursary Applicant Information’.

You have the right to access personal information that we hold about you and to request correction of erroneous personal information about you. Should you wish to do so, please write to the Access to Information and Privacy (ATIP) Coordinator at the following address:

You may also write to the ATIP Coordinator by email, at daiprp-atipd@bac-lac.gc.ca.

To inquire about applicable legislative authority or to withdraw participation from this bursary, please contact the Price McIntosh Bursary coordinators at 819-997-0893 or 1-844-757-8035 (toll-free in Canada and the United States). If you use a teletypewriter (TTY), call 613-992-6969 or 1-866-299-1699 (toll-free in Canada). You may also contact the coordinators by email, at bourse-bursary@bac-lac.gc.ca.

If you require clarification about this Privacy Notice, please contact LAC ATIP at 613-996-5115 or 1-866-578-7777 (toll-free in Canada and in the United States).

Please note that you have a right to make a complaint to the Office of the Privacy Commissioner of Canada (OPC) regarding our handling of your personal information. To do so, please contact the OPC at 1-800-282-1376.

I have read and agree to the terms of the Privacy Statement

• Yes
• No

Note: If you answer “No,” your application cannot be considered. Should you have any questions, please do not hesitate to contact Library and Archives Canada.

Section F: Signatures

By signing below, you warrant and attest that you are of the age of majority in your province or territory of residence, or an emancipated minor, and that the information you have included on your application form is accurate and true.

If you are under the age of majority, you must have a Parent or Guardian authorize the application below.(see note)

Applicant’s Authorization

Signature: ________

Note: The age of majority is 18 years of age in Alberta, Manitoba, Ontario, Prince Edward Island, Quebec and Saskatchewan. The age of majority is 19 years of age in British Columbia, New Brunswick, Newfoundland and Labrador, the Northwest Territories, Nova Scotia, Nunavut and Yukon.

Parent’s or Guardian’s Authorization

Name: (First/Last) ___________

Signature: __________

Contact information

For any questions, please contact the Price McIntosh Bursary coordinators:

Email: bourse-bursary@bac-lac.gc.ca
Telephone: 819-997-0893
Toll-free: 1-844-757-8035 (toll-free in Canada and the United States)

Submission

Application deadlines:

Applications must be received by September 24, 2025, 11:59 p.m. (Pacific Daylight Time).

Thank you for your application.