Application  Form

Name: ____________________________________________________________

Note: Individuals and Groups may submit an application

Address: _________________________________________________________

____________________________________________________________________

Phone:

____________________________________________________________________

Email:

__________________________________________________

  1. How are you proposing to use the award money? Please be very specific (e.g. details of workshop, conference). Attach any relevant material.

  1. How is this training consistent with OPIRG-Guelph's Mandate?

  1. How much does the training cost? Awards of up to $800.00 are awarded annually.

  1. If the training is more than $800 00 how will you cover the remaining cost?

  1. When will the program occur? If it will not occur within the twelve (12) months following the submission deadline, please explain.

  1. Who is offering the training. conference, or related program you wish to attend?

  1. How will you share your knowledge with OPIRG-Guelph members? Please be very specific (e.g. holding a workshop)

  1. Anything else you would like to tell us?

Applicants must be members of OPIRG-Guelph (community member, undergraduate or graduate student at University of Guelph) or a general community member. OPIRG Guelph Board and unionized staff members are ineligible for the Award. You agree to have your name(s) mentioned in OPIRG Guelph promotional material if this application is successful.

Signature: ____________________________________________

Date Received: ________________________________________

Staff Signature: ________________________________________