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Lecture Grant (LG) Application Form The following personal information is being collected under the authority of Section 13(1) of the Alberta Personal Information Protection Act (PIPA) to assess your application. If you have questions about the use and disclosure of your personal information, contact the GSA at 780-492-2175. Please Print Clearly Section A: STUDENT GROUP INFORMATION Group Name: Focus and Purpose of Group: Is your group registered as a graduate student group through Student Group Services in SUB? □ Yes □ No (if no, please contact Student Group Services in SUB to register) Section B: CONTACT INFORMATION Two students from the group will act as official contacts (one primary and one alternate) to the GSA. The GSA will contact ONLY these individuals. Name: Campus Telephone: Campus Address: Alternate Telephone: E-Mail Address: Primary Applicant Alternate Applicant GSA Grants: Lecture Grant Application Form Page 1 of 4
Section C: SPEAKER AND LECTURE TOPIC Name of Invited Speaker: Title of Lecture(s): Event Location(s): Date(s) of Event(s): i) Give a brief description of the lecture(s). ii) Explain how the lecture(s) is/are an academic activity. GSA Grants: Lecture Grant Application Form Page 2 of 4
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Page 7: Section E: DEPARTMENT CHAIR (OR DES

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