Application Form

Graduate Students Association Awards
Please review this important information before submitting an application.

Awards Application Form

Award Notification 

Only successful applicants will be notified in writing via e-mail that their nomination for the Outstanding  Distinction Award has been selected as a successful recipient. Successful recipients of the award must  submit this follow-up form for payment processing. 

Privacy and Data Collection 

All information requested on this form is collected to aid in processing your application for an AUGSA  award and/or bursary. This information is collected following the standards set by the Personal  Information and Privacy Act (PIPA). It is required to determine your eligibility for the award and/or  bursary and may be used for research and statistical analysis. Personal information provided in  applications is kept confidential, and only disclosed for processing payment. 

If you have any questions about the collection or use of this information, please contact the GSA’s  Awards Committee Chair at  

Nomination Information

I nominate (or self nominate):
For the:
I enclose the following support documents
1. A letter of nomination from you describing why the Nominee should receive the Award.
2. A resume from the candidate outlining their qualifications as it relates to the award.
The candidate for this award must be an Athabasca University student, actively enrolled in a graduate-level program at the time of nomination.

Contact Information

Student ID:
First Name:
Last Name:
Date of Birth (if applying for the Over 50 Award):
Title and Work/Volunteer Setting:
Nominator’s Name:
Title and Work/Volunteer Setting:
Program of Study:
Credits Completed:
If you are a recipient of this award, please select this box if you give us permission to publish your name and the award you have received:
Nomination Support Documents (please label the file with Student ID and Last Name):

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