Phone: 780.492.3499 Fax: 780.492.0692
http://uofa.ualberta.ca/graduate-
studies
Alberta Graduate Excellence Scholarship
(AGES) Student Declaration Form
Personal information on this form is collected under the authority of Section 33(c) of Alberta’s Freedom of Information and Protection of Privacy Act for authorized
purposes including admission and registration; administration of records, scholarships and awards, student services; and university planning and research. Students’
personal information may be disclosed to academic and administrative units according to university policy, federal and provincial reporting requirements, data sharing
agreements with student governance associations, and to contracted or public health care providers as required. For details on the use and disclosure of this
information call the Faculty of Graduate Studies and Research at 780-492-3499 or see http://www.ipo.ualberta.ca/.
KILLAM CENTRE FOR ADVANCED STUDIES
2
-29 TRIFFO HALL
Instructions:
(1) Student must first review the Alberta Graduate Excellence Scholarship (AGES) eligibility requirements in FGSR website.
(2) To be considered, students must complete all the fields, then print and sign the declaration below. It is your responsibility to
ensure that form is complete and submitted as per below:
AGES Indigenous:
Students must apply directly to FGSR by completing the online application in the GSMS Awards Portal. Students must
upload this form to their online application. Please visit FGSR website for details.
AGES by Department Nominations:
Students must submit this form to their home Department by the department deadline.
Students must consult with their department for their internal deadline and process. Departments will select and
nominate students based on the department’s AGES allocation.
UA Student ID
Student Last Name, First Name and Middle Name
Department
Citizenship Status
Note: Due to COVID-19 and the impact it has had on post-secondary institutions and the way classes may be
delivered remotely, students do not have to reside in Alberta, however they must be enrolled full-time at the
University of Alberta.
It is the student’s responsibility to ensure their mailing address and citizenship status are updated in Bear Tracks.
Declaration:
I declare that to the best of my knowledge, the information provided in this application and attachments is true and that no
material has been withheld.
AND
I authorize my post-secondary institution to disclose information collected on this application form, my program of study and any
award details (if I am selected) to Advanced Education, and I authorize Advanced Education to collect this information from the
post-secondary institution for the purposes of administering the Alberta Graduate Excellence Scholarship under the Student
Financial Assistance Act and the Alberta Heritage Scholarship Act, including confirming my eligibility and suitability for this award,
for program evaluation and for research and statistical analysis.
Date (MM/DD/YYYY)
*This form can be electronically (image of signature) signed or signed and scanned.
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