DEAN OF STUDENT AFFAIRS
STUDENT INITIATIVE FUND
Please read the document that outlines the objectives and criteria of the Student Initiative Fund prior to
completing this application form.
Name of Club/Organization/Person: _____________________________________________________________________________
Date of Event: __________________________________________________________
* To be considered for funding, applications must be received at least 4 weeks prior to the event
* Applications may take up to 8 weeks to process
Name of Contact Person: _________________________________ Phone: ______________________ Fax: ___________________
Have you/your Club/Organization received funding from the Student Initiative Fund in the past 2 years?
No Not Sure Yes (Amount(s):________________ Event/Project(s) ____________________Year(s)_______________)
Organization ________________________________ Queen’s University Account #: _______________________________
(if applicable) (if applicable)
Student Number:_____________________________ SIN #: _______________________________
(if applicant is an individual; please note that funds given to an individual are considered taxable income )
Fundraising Activities: ___________________________________________________________________
Other Possible Funding Sources: _______________________________________________________________
(External & Internal)
Confirmed Sources of Funding Amount
Please ensure your application is complete with:
A letter outlining how your event matches the criteria and requirements of the fund and details of
Proposed budget that illustrates detailed expenses, fundraising income, other possible sources of funding,
confirmed funding and the need for further funding
Letter(s) of Endorsement (from faculty/organization)
Incomplete applications will not be processed
if required, please seek assistance while completing the application via firstname.lastname@example.org
By signing below you are indicating that to the best of your knowledge the information given in this application
is accurate and that any funds awarded to you or your Club/Organization will be used as described. You also
commit to submitting a complete and thorough report as indicated in section (7) of the Eligibility and
Requirements section in a timely fashion.
Name of Person Submitting the Application:_____________________________________________________________
The personal information on this form is collected under the authority of the Royal Charter of 1841, as amended. The
information collected on this form will be used for tracking purposes and will be used to contact you. Student numbers are
collected to verify your current status as a student as required under the terms of the fund. The collection of your social
insurance number if required is for purposes of reporting income to Canada Revenue Agency. If you have any questions or
concerns about the information collected or how it will be used please contact Kim Murphy, Finance and Staffing Manager,
office of the Dean of Student Affairs, 300 Gordon Hall, 613-533-6000 ext. 78664
For Office Use only:
Application Complete? __________________ Project Meets Criteria?____________________
Project Approved?______________________ Amount Awarded _______________________
Budget Approval _______________________ Cheq Req/Journal ________________________
Report Received _______________________
DEAN OF STUDENT AFFAIRS
STUDENT INITIATIVE FUND
Objectives and Principles:
The Student Initiatives Fund is held by the Associate Vice-Principal and Dean of Student Affairs as discretionary
financial support for projects that enhance the quality of the student experience at Queen’s.
The Fund exists to support projects that are dedicated to the principles of personal and community development
and, in particular, that provide extra and co-curricular educational opportunities for students to build leadership,
citizenship, intercultural awareness and/or community-building skills.
Eligibility Criteria and Requirements:
1. The applicant must be a student registered at Queen’s at the time of application.
2. The project must be non-profit in nature. This grant program is intended to support co-curricular
experiences for students. Therefore, efforts associated with credit-bearing courses are generally not
eligible. However, course-related activities which benefit students more broadly and fulfill other criteria of
the grant program will be considered as funds are available.
3. Applicants should provide a clear sense of the project’s purpose and goals, which will be evaluated
against the objectives and principles of the Fund.
4. A detailed proposed budget must be attached to a request for funds.
5. Applicants must provide evidence of efforts to obtain assistance from elsewhere.
6. Applicants should identify how and/or where the project will contribute positively to the image and
reputation of Queen’s.
7. If support is issued to an individual, funds will be subject to disclosure as income. In this case a Social
Insurance Number must be provided.
8. Successful applicants are expected to report in writing to the AVP/Dean after the completion of their
activity. The report should summarize the event, include copies of media coverage, a financial statement
listing budgeted versus actual figures, as well as other information that might be of interest to the
The approval and amount of funding will be contingent on:
1. The availability of funds and the total amount of requests received throughout the fiscal year.
2. The alignment of the project goals and outcomes to the objectives and principles of the Fund.
3. The extent to which the project is innovative and/or requires seed funding.
4. The broadness of the project’s relevance to and impact on students.
5. The degree of initiative taken to raise funds from other sources.
6. The contribution of the project to the positive image or reputation of Queen’s
The fund is not intended to provide an annual source of income for recurring projects. First priority will be given to
funding requests for new initiatives and seed funding.
Note that applications for funding to cover prior year deficits will not be considered.
Students must complete an application form, attach a proposed budget and any endorsements that support their
request, and submit this information to the Office of the AVP/Dean of Student Affairs located in 300 Gordon Hall.
For more information, please contact the Office at 533-6944 or email@example.com