Name: ___________________________________________________ Student Number: _________________________
Michener E-Mail:__________________________________ Program: ____________________________ Year: 1 2 3
Name of Conference/Workshop/Event: _________________________________________________________________________
Start & Completion Dates: From: ______________________ To: ___________________________ Number of Days: ___________
Will you be presenting at the Conference/Workshop/Event: Yes No Are you attending for networking purposes: Yes No
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Expense Items
Estimated Costs*
Document Required
Registration Fee
Conference Brochure/Workshop Outline/Registration Confirmation
Accommodation
Tentative Reservation Notice
Travel
Train/Flight/Bus/Car (please include quotations and/or receipts)
Other
Estimated Total
*Please note: The Student Professional Development Grant does not cover meal expenses
Grant Advance
Advanced @ 75% of total estimated grant Yes No
Final Expenses
Notes:
Total Less Advance
Final Amount Owed to Student
All final documents/receipts have been received Yes No
All documents have been reviewed by: ____________________________________ Date: ________________________________
APPROVED BY: _____________________________________________ DATE: ____________________________________
PART C: Reference
STUDENT PROFESSIONAL DEVELOPMENT FUND:
http://michener.ca/admissions/scholarships-bursaries-and-awards/student-grants/student-professional-development-grant/
EXPENSE CLAIM FORM
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