Global Opportunities Awards

Please complete the application form in full. Incomplete applications will not be considered.





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Name of Western University Staff/Faculty/Department organizing, sponsoring or approving your participation in this activity: (i.e.who we can contact to verify your participation)



 


 

 

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Indicate if either of the following statements apply to you (if they do not please leave this section blank)
 I am a member of the Professional and Managerial Association (PMA) at Western
 I am the spouse or dependent of a member of the Professional and Managerial Association (PMA) at Western.
Please list PMA member name:
The PMA office will be contacted for verification
Please write a short statement (maximum 500 words) outlining how this experience will assist you in developing the qualities of a global citizen, what you expect to learn through the international experience that will contribute to your success in your field of study/profession and how you will be an effective Ambassador for Western.

To the best of my knowledge, the information provided in this application is correct and true and of my own effort. I authorize The University of Western Ontario to release my academic record to the Global Opportunities Awards selection committee.