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


Please attach two certificates of completion for OWL Pre-Departure Modules 1) Health and Wellness and 2) Intercultural Engagement. See Western International for further instructions.

Certificate of completion - Health and Wellness Module :
Certificate of completion - Risk Management:
Please attach a letter of support from a Western faculty member who supports your participation in this experience
IMPORTANT: Maximum size is 10MB. Special characters will be removed from the File Name.

Disclaimer and Signature

Return to Student Experience Website

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