Experiential Opportunities Fund



Applicant Information




Event Information




Estimated Budget
(possible expenses = Flight/Travel, Accommodations, Taxis/Uber/Public Transit, Meals, Conference Fees) *Please estimate in Canadian Dollars (CAD)


$
$
$
$
$
$


Essay Section




Attachments


Please attach two certificates of completion for OWL Pre-Departure Modules 1) Health & Safety and 2) Cultural Adjustment. See Western International for further instructions.

Certificate of completion - Health and Safety Module :
Certificate of completion - Cultural Adjustment Module:
IMPORTANT: Maximum size is 10MB. Special characters will be removed from the File Name.

Disclaimer and Signature







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The personal information on this form is collected under the authority of the University of Western Ontario Act, 1982. The information is collected for the purpose of processing process your application, determining your eligibility for the Western Student Experience Support Fund, and reporting to donors, government entities, and faculties, departments and/or schools within the University. For further information about this collection, please contact the Director of Administration, Student Experience, The University of Western Ontario, London ON, N6A 3K7; Phone 519-661-2111 ext. 84882.

This program will be subject to ongoing review and revision to reflect Western University's Student Experience strategy and available resources.

Last revised: December 16, 2015