1812 Sir Isaac Brock Way

St. Catharines, ON L2S 3A1

Tel: 905-688-5550 ext. 4490
APPLICATION FOR FGSPA CONFERENCE FUNDS Fax: 905-688-0748
brocku.ca/graduate-studies

Please upload this document as part of your Application for FGSPA Conference Funds. Your program will assist you in
procuring necessary approvals and signatures on this document after you complete and submit the remainder of the
online Application for FGSPA Conference Funds.

Student Number: Student Name:

Program: Conference/Purpose of Travel:

Summary of Expected Expenses (e.g. hotel):

Total Cost of Expenses: $

☐ Please check this box if you are also applying for the Provost’s Discretionary Fund. More information is available
here: https://brocku.ca/teaching-learning/provosts-discretionary-fund/. If you check this box, you do not need to download nor
complete the separate application form on the Provost's Discretionary Fund website to apply.

Student’s Signature: Date:

Brock University protects your privacy and your personal information. The personal information requested on this form is collected under the authority of The Brock University
Act, 1964, and in accordance with the Freedom of Protection of Privacy Act (FIPPA) for the administration of the University and its programs and services. Questions about
this collection can be addressed to the Executive Assistant to the Vice-Provost & Dean, Graduate Studies, Brock University, 905-688-5550 ext. 5261.

For completion by Graduate Program Director (GPD):

GPD Name:

GPD Signature: Date:

I confirm that the conference is of direct benefit to this student’s graduate program.

For completion by Student or Program Admin: Please enter the total amounts covered, as applicable.

Program: $ Faculty: $ Supervisor: $

Travel Award: $ Other, please specify: $

Amounts requested from: FGSPA: $ Provost’s Discretionary Fund: $

The below sections are only required if the student is applying for the Provost’s Discretionary Fund.
For completion by Supervisor: Please provide any comments on the student’s request.

Supervisor Signature: Date:

For completion by Dean/Director: Please provide any comments on the student’s request.

Dean/Director Signature: Date:

Last Updated: April 2024