Confirmation of Student Status – Part-Time

Confirmation of Student Status – Part-Time
2204 (1 of 2)
*f002204*
This form is intended for persons who must obtain confirmation of
part-time student status from an educational institution recognized by
Aide financière aux études for a study period for which they did not
apply for student financial assistance. Such confirmation exempts
them from the obligation to repay, during the study period indicated,
their student loan debt contracted under the Loans Program for
Part-Time Studies.
Reserved for Aide financière aux études
Please submit this fully-executed form by uploading it right into your
online file using the Submit a document tab. To learn how, see the
Submit a document section of our Web site (www.afe.gouv.qc.ca).
Section 1 – Student Information
Permanent code assigned by the Ministère
de l’Éducation, du Loisir et du Sport
Last name
Date of birth
First name
Number
Apartment
Y
Social insurance number
MD
Direction
Street
(North, South, East, West)
Municipality
Municipality (cont.)
Province
Telephone number (home)
Postal code
Area code
Other telephone number
Country
Area code
Extension
E-mail address
(If you provide your e-mail address, you will receive your correspondence by E-mail.)
Do not forget to have an authorized person
at your educational institution fill out
the section on the back.
Reserved for Aide financière aux études
Ministère de l’Enseignement supérieur, de la Recherche et de la Science
Aide financière aux études 1035, rue De La Chevrotière
Québec (Québec) G1R 5A5
22-1525-15A (rev. 15-04)
2204 (2 of 2)
Permanent code assigned by the Ministère de l’Éducation, du Loisir et du Sport
Section 2 – Attestation of the Educational Institution
Have this section filled out by an authorized person of the financial assistance office of your educational institution or the Registrar’s office.
Name of educational institution
Number
Code of educational institution
Direction
Street
(North, South, East, West)
Municipality
Municipality (cont.)
Province
Postal code
Telephone number
Country
Area code
Please give the name of the program.
Program code
To
From
I hereby confirm that the person identified in section 1 is or was pursuing part-time studies
during the study period specified: .................................................................................................
If applicable, check one of the following boxes and give the event date.
Extension
Y
Date
Y
MD
Y
MD
MD
Withdrawal..................................................................................................................................
Date
Y
MD
Cancellation................................................................................................................................
With respect to the educational institutions in or outside Québec that are recognized for the purposes of loans under the Loans Program for Part-Time
Studies, a person is deemed a part-time student during a study period if he or she is enrolled for the following number of course hours or credits:
Secondary school vocational education: 76 to 179 course hours or 6 to 11 credits
College: 76 to 179 course hours or 2 or 3 courses
University: 6 to 11 credits
Signature of the authorized person at the financial assistance office or the Registrar
Date
Y
X
Official stamp
(compulsory)
MD