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Summary: Revised March 17, 2010
Please submit this application form to your academic unit.
FGSR Funding Application Form
For Graduate Studies Scholarships, Graduate Research Awards
Teaching Fellowships
Doctoral - Date of First Semester ________________ Masters - Date of First Semester ____________
Supervisor's Name: ________________________ Major/Department/Area _________________________
Semester you are applying for Fall/Winter Spring/Summer Year: ____________
Check one: Canadian Citizen Permanent Resident Temporary Resident (study permit)
Mr. Ms
Mrs. Miss Surname: ____________________________ First Name & Initial: ____________________
Mailing Address at time of application: (notification of award will be sent here) Phone (Home) _________________
________________________________________________________________ Phone (Work) _________________
________________________________________________________________ Postal Code _________ _________
Email Address: ___________________________________________________
U of R Student Number ___________________________
Social Insurance Number (SIN) or Temporary Tax Number (TTN): REQUIRED FOR YOU TO BE PAID If you
have never been paid through the University of Regina, please submit your SIN or TTN to the FGSR Scholarship Office.
· How many semesters have you received funding from the FGSR during your current program? ________ (Master's
maximum of 5; PhD maximum of 9).
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