Consortium Change of Information/
Operational Bursary Form

Information in this form cannot be saved and completed later. Please make sure that you have all necessary  information.

Please make sure that you have read the following documents:

Please fill out this form before October 15 of each year to update the GSA on your Consortium’s information, executives, and GRC representatives, and to receive your operational bursary of $100 or $0.50 per member, whichever is greater, to a maximum of $350 per year (April 1 – March 31).

Fill out this form at any point during the year if there have been any changes to your Consortium.

If you have any questions, please contact the Governance Coordinator at

Information in this form is collected under Freedom of Information and Protection of Privacy (FOIP), this information will only be used for purposes relating to the DGA/Consortium program.

* Required

    Executive Information

    Is the president a GRC representative?

    Executive 2

    Is Executive 2 a GRC representative?

    Executive 3

    Is Executive 3 a GRC representative?

    Executive 4

    (If applicable)

    Is Executive 4 a GRC representative?

    Do you want to apply for an operational bursary if eligible?

    I acknowledge that I have read the Bylaws of the Graduate Students' Association and the DGA Policy and I agree to all terms and conditions imposed by these documents*.   Agree

    Signing Authority Signature

    By signing this document, I confirm the information provided to be true and accurate to the best of my knowledge*.   Agree