Checklist For Graduate Student Travel / Research Bursary (Page 4 of 4) in pdf

Checklist For Graduate Student Travel / Research Bursary Page 4

If YES, When?

TRAVEL/

PRESENT

ACCOMMODATION

RESOURCES

Dollar Amount

COSTS FOR EVENT

Dollar Amount

Gov’t. Student Loan:

Airfare:

Student Line of Credit:

Surface Travel:

Scholarship:

Accommodation:

T.A.

Registration Fees:

R.A.

Photocopying:

External Scholarships:

Food:

PT Employment:

Travel Visa Costs:

Miscellaneous:

TOTAL:

Please state why the bursary is required and how your participation in the conference / research will enhance your

academic experience. (You may include a separate sheet.) Please note your department may request additional

information regarding your research interests and accomplishments to date.

I have read and understood the Terms and Conditions of the Graduate Research Bursary. I hereby certify

that the information given in this application is correct. I fully understand that any false statements made by

me on this application or any supplement thereof may be sufficient cause for rejection of my application. I

UNDERSTAND THAT IF I AM APPLYING FOR THIS BURSARY IN ORDER TO COMPLETE TRAVEL OF

ANY KIND AND IF I DO NOT COMPLETE THE TRAVEL I WILL BE EXPECTED TO PAY BACK THE

BURSARY IN FULL TO THE FACULTY OF GRADUATE STUDIES AND RESEARCH.

Date:

Signature:

At Carleton University, we recognize and respect the importance of privacy. Personal information that we collect is kept confidential. In

accordance with section 41 of the Freedom of Information and Protection of Privacy Act, Carleton University will only use the information in its

custody or control in the following circumstances: where the individual identifies the particular information and consents to its use; for the

purpose for which it was collected or a consistent purpose (ie. a purpose which the individual might have reasonably expected)

Revised: January 2010

Checklist For Graduate Student Travel / Research Bursary Page 4