SGS Graduate Student Emergency Fund

Request for Assistance (Including COVID-19 Emergency Assistance Funding)

Email completed form to sgs@mun.ca
NOTE: Please name the file as follows: LName, FName (eg. Smith, John.pdf)

Date:

Student Name:

Student Number:

Mailing Address:

Email:

Program: FT PT

Student Status:  NL Resident  Canadian/PR International

Are you currently receiving baseline funding from the School of Graduate Studies? Yes No

Financial Impact
Please tell us about your situation and if applicable, how you have been impacted by recent COVID-19
events (ie layoffs, inability to perform research etc.)

Budget
Please outline your approximate monthly expenses. This will help us assess your request. Please note that,
if approved for financial assistance, the amount awarded may not cover all expenses outlined below.
Rent
Utilities
Internet/Cable
Groceries
Other

Total
Is there anything else you would like us to know about your situation?

Memorial University of Newfoundland protects your privacy and maintains the confidentiality of your personal information. This
collection of personal information is authorized under the Access to Information and Protection of Privacy Act, 2015, SNL2015 CHAPTER
A-1.2. Information collected will be stored, managed, and/or updated by the School of Graduate. The information is collected and used
for the assessing of emergency funding for graduate students. If you have any questions about the collection and use of your
information, please contact us at sgs@mun.ca.

This section to be completed by SGS:

Amount Awarded: _______________________________

Committee Members:

____________________________________________
Andrew Kim, Director of Enrolment, SGS

____________________________________________

Carol Sullivan, Manager of Awards and Scholarships

To submit completed form:

1. Name the file LName, FName (eg. Smith, Johns.pdf)
2. Email completed forms to sgs@mun.ca