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					                                                                                       Revised June 2012
Deadlines:     apply any time


Please note:

You will need to submit:
    1 electronic copy (in a single file & bearing all required signatures) of your application to
    You will receive an E-mail confirmation that your application has been
    received by the Office of Research Services within 5 working days.
    Note: Department photocopiers can be used to scan and then email your application.

1.     If you are on a Limited Term appointment, you must have completed the PhD, or equivalent
       degree, to be eligible.
2.     Attach a preliminary program.
3.     All conference applications must be accompanied by a letter of support from the applicant’s
       Chairperson and Dean, indicating direct and indirect sources of support, if any, to be provided
       by the Department, the Faculty and other internal and external sources.

You must attach a letter of support from your Chair and Dean for this conference.

Before completing, please consult the following documents:
      Eligibility (
      General Regulations (

Note: Boxes will expand as needed to accommodate extra text.

General Information

 Name of Applicant:
 Contract Status and Rank:
 Year PhD Awarded:
 Telephone Extension:                  E-mail:

Conference Information
 Name of Conference:
 Location of Conference:
 Dates of Conference:
 Name of Sponsoring

 Estimate of the Number of
 Persons Attending the
 Amount Requested
 (max. $5,000):

Conference Details

1.    The conference/workshop must be sponsored by an academic or professional institution or
      other scholarly association. Describe fully the sponsoring organization and the extent to which
      it may have a scholarly reputation.

2.    Does the conference/workshop include international participants?

3.    Indicate whether a refereeing procedure has been used in the selection of papers. Outline the

4.    How will your involvement with this conference/workshop contribute to your growth as a

5.    How will hosting this conference/workshop increase Laurier’s research profile?

6.    Indicate and substantiate whether the abstracts or the papers will be published in a set of

Applicant’s Research Record

7.    List recent internal and external research awards (last four years only), including grant titles,
      amounts per year, and your status on the grant (e.g. PI, co-applicant).

8.     Current applications (include all grants to be applied for from external agencies in this
       academic year).

9.     Please explain the relationship of the funding requested in this application to funding
       currently held or applied for.

10.    List recent research presentations and publications (last three years only). In the case of co-
       authored publications, please list either in alphabetical order or senior author first.
       Publications that have been accepted with revisions, or that are in press, may be included. If
       there are any gaps in your publication record, you may provide a brief explanation.


Eligible costs
     Personnel costs
     Travel costs for presenters (including keynote speakers)
     Travel costs for Canadian student presenters (whether studying in Canada or abroad)
     Subsistence costs for presenters (including keynote speakers)
     Subsistence costs for Canadian student presenters (whether studying in Canada or abroad)
     Administrative costs
     Translation/interpretation
     Teleconferencing/videoconferencing
     Promotion and dissemination
     Publication of proceedings

All rates must comply with the Laurier Research Expense Guidelines.

 Travel and Transportation                                                      Costs:
 Dates of Travel           Place                      Mode

 Cost per day:             # of days
 Allowance per day:        # of days

 Other Expenses: (See above. Specify nature, rate and total of each):

 Indicate source and amount of revenues for the conference

 TOTAL $                (may not exceed $5,000)

Budget Justification

For each item listed above, give a brief justification in terms of the needs of the research. For travel
and subsistence costs, indicate the names/roles of persons for whom funding is requested.


☐      I have read the guidelines/regulations for this grant category.
☐      I do not currently hold a conference/workshop grant, have a conference/workshop grant in a
       deficit position or have an outstanding final report on a conference/workshop grant.
☐      I have attached a preliminary program.
☐      I am submitting 1 electronic copy of this application (in a single file & bearing all required
       signatures) to Note: department photocopiers can be used to scan and
       then email your application.


                     Signature                                           Date
The information in this application is complete and correct.

I am cognizant of this application for funding.

Department Chair
I am cognizant of this application for funding.

Faculty Dean

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