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The bursary application system is closed and reopens on February 1st. The next application deadline is March 15th, 2023. More Info

Application Form

Graduate Students Association Outstanding Distinction Award
Please review this important information before submitting an application.

Description of Award 

This award recognizes Athabasca University faculty, students, and staff who have demonstrated a high  degree of leadership and engagement in their communities, their studies, and/or their professional lives.  Only students qualify for the $1,125 award amount. Each year five student awards will be given, one  faculty award, and one staff award. If there are no nominations received in a certain category, there will  be no award given for the category. 

Application Submission Deadline 

  • Application deadline is October 15th annually.  

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 vpacademic@augsa.com.  

Personal Information

Student ID:
Last Name:
First Name:
Date of Birth:
Mailing Address:
City:
Province:
Postal Code:
Country:
Primary Telephone Number:
Email Address:

Enrollment Information

Program of study:
How many credits completed:

Applying For

Please select the award(s) you are applying for:

Signatures

By signing this application, I confirm that:
1. I have answered all required fields on this form that are applicable;
2. All information provided is true and complete;
3. I have read the Awards Terms of Reference in the Policy Handbook for the GSA Bursary; 4. I authorize the GSA to use the information provided on this application to determine my eligibility for the bursary and for research and statistical analysis, subject to the standards outlined by PIPA;
4. I authorize the GSA to use the information provided on this application to determine my eligibility for the bursary and for research and statistical analysis, subject to the standards outlined by PIPA;
Applicant Name:
Applicant Signature:
Todays Date:

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