Saint Mary s University International Development Initiative Fund (IDIF) Application. Application period: March 1-April 1, 5pm.

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1 Saint Mary s University International Development Initiative Fund (IDIF) Application Application period: March 1-April 1, 5pm. The personal information provided in this form will be used solely for the purposes of adjudicating the funding applications, and will not be released to any third parties without the consent of the applicant. The IDIF follows the University s policy on Freedom of Information-Protection of Privacy (FOI-POP). Please only apply if you meet the following criteria: You are a registered SMU student and are currently taking classes at SMU or you have graduated within 6 months. The activity for which you are applying for funding consists of one of the following: o You are participating in a project with an NGO, non-profit organization, volunteer program, etc., or you are initiating a project of your own design. o You are participating in a development project that directly benefits a developing country or a community in a developing country. This project must be targeted at a developing region and it must directly benefit this focus area. o You are a SMU student and wish to begin your own development initiative that will contribute to an area in the developing world. o You have a research project aimed at aiding a developing area. o Your project will last a minimum of 30 days and meets all IDIF requirements (read in Policy Outline). Please note that the IDIF is unable to fund the following sorts of activities: - You wish to start an initiative that will not specifically benefit a developing country. - You wish to pursue research that will not immediately benefit the developing world. (Ex: Research focused on a topic, such as health, which is not specifically relevant to a developing country.) - You are participating in an initiative either locally or abroad that does not aim at improving an area in a less developed country. - Your initiatives will benefit an underdeveloped region in a developed country. Applicants are responsible for the completeness of their applications. Any incomplete applications will not be considered by the board of directors. Applicants should give serious and thorough consideration of their proposal because any significant change in the profile of the proposed project will necessitate a new application to the IDIF. Page 1 of 5

applicant. The IDIF follows the University s policy on Freedom of Information-Protection of Privacy (FOI-POP).

2 Personal Information Surname: Given Name: Birthdate: / / (dd/mm/yyyy) Gender: Male Female Prefer not to disclose: Student Number: A Citizenship: Travel Insurance: SMUSA Health Plan Personal Coverage: Provider & Policy #: Expiry Date: First Language: Other Languages: Spoken Written Spoken Written Contact Information Phone Numbers: (c),(h) Academic Information Faculty: Major: Minor: Full time student Part time student Year of Study: # of credits completed to date: Expected Graduation Date: / (mm/yyyy) Date Graduated (if already graduated): / (mm/yyyy) Initiative/Program If you are traveling abroad, please indicate to which country or region: Have you checked the Department of Foreign Affairs (DFAIT) website for the risk level of this county or region? Country Language(s): Proficient in Country Language? Yes No Period Abroad: (dd/mm/yy) to (dd/mm/yy) What best describes your initiative: Volunteer Program University Program (including research) Other Established Organization Your own created project/initiative Describe: * Applicants are responsible for ensuring they have a valid passport and necessary visas Do you have a valid passport? Yes No Expiry Date Page 2 of 5

time student Part time student Year of Study: # of credits completed to date: Expected Graduation Date: / (mm/yyyy) Date Graduated (if already graduated): / (mm/yyyy) Initiative/Program If you are

3 Projected Budget Expenses Fees (if applicable) -Accommodation/Food included? Yes No Flights Insurance Supplies* Accommodation Food Other: Expenses Total Sources of Funding Personal Contributions Other Grants & Awards Other Funds: Sources of Funding Total How much money are you requesting from the IDIF? *A detailed list of supplies and humanitarian aid (if applicable) will need to be presented with the application. Original receipts of all expenses must be provided to the Director of the Fund. The fund will not support the purchase of equipment for project initiatives. *Normal grants under the IDIF are in the vicinity of $1000 CAD, however, the fund will give consideration to especially worthy applicants for funding up to a maximum of $2000 CAD. Checklist Please use the following list to ensure that you have included all the required documents. Submit these to the IDIF in PDF form: Completed SMU International Development Initiative Fund Application form Letter of Intent (type written, 1 page maximum, single-spaced, 12pt font), outlining: - the work you will be doing and its intended beneficiaries, - why the initiative/opportunity is important to you, and - how it will impact your career plans and/or future goals Proof of enrolment or proof of graduation if a graduate applying within 6 months of graduation. CV (i.e. a resume): be sure to include information on awards, past volunteer work development work, and any extra-curricular activities on/off campus. Page 3 of 5

you requesting from the IDIF? *A detailed list of supplies and humanitarian aid (if applicable) will need to be presented with the application.

4 Submit these as hard copies in a sealed envelope: Project Counterpart Letter (This is a letter from the organization you will be working with confirming your participation in the project. It must be signed by the counterpart. If you are working with a Saint Mary s Professor they may provide a letter of recommendation and a counterpart letter but they must be separate documents). Two reference letters from Saint Mary s professors/instructors. Letters should include the length of time, and in what capacity, the referee has known you. The letter should address both your academic and personal qualifications. Personal references will no longer be accepted. List any courses you have taken that are relevant to your project or area you are traveling to. (Language, development, history, political science, etc.) *Note: Successful applicants will receive 70% of their award before they leave for their project and the remaining 30% when they return. In order to receive the remaining 30% applicants must submit: 1. a detailed 1 page report including photographs, if available, to the IDIF Board of Directors summarizing their experience abroad and itemizing disbursement of IDIF funds, 2. if the trip requires air travel all boarding passes must be submitted or 3. if the trip does not require air travel all receipts of costs covered by the award must be provided. All applicable items must be given to the Board of Directors within 30 days of the applicants return from their project in order to receive their remaining award. Page 4 of 5

Two reference letters from Saint Mary s professors/instructors. Letters should include the length of time, and in what capacity, the referee has known you.

5 WAIVER In consideration of my application being considered I hereby agree to waive any and all claims that I may have in the future against SMUSA, its members, officers, employees, volunteers, agents and independent contractors for any loss, damage, injury or expense that I may suffer, as a result of my application hereunder or of any grant I may receive. Declaration I declare that the foregoing information is to my knowledge true, complete and accurate. I understand that the submission of false information will result in the disqualification of my application, and may make me subject to proceedings under the Disciplinary System of Saint Mary s University. I have read and understand this application form in its entirety. Signature: Date: Please submit counterpart letter and reference letters in a sealed envelope and drop off/mail at the SMUSA desk on the 5 th floor of the Student Center and label: International Development Initiative Fund SMUSA Student Centre Building, 923 Robie St., 5th floor, Rm 553 Halifax, NS, B3H 3C3 C/O Ross Grant Fund Director All other documents are to be submitted electronically, in PDF form, to the IDIF director at: smu.idif@gmail.com All applicants are encouraged to review the IDIF Policy Outline. For further information or questions, please contact: Ross Grant, Fund Director International Development Initiative Fund walter.r.grant@gmail.com or smu.idif@gmail.com Or Noah Best, President SMU IDS Undergraduate Society noahbest@hotmail.com or ids.smu@gmail.com Page 5 of 5

Declaration I declare that the foregoing information is to my knowledge true, complete and accurate.

International Development Initiative Fund. Noah Best- IDS Society President

SMU IDS International Development Initiative Fund Policy Outline January 2014 Ross Grant- Fund Director Noah Best- IDS Society President This outline is a modified version of the Change for Change project