Wilfrid Laurier University  
Canadian Excellence

Student Life Levy Application

Please complete the following online application.

Questions can be directed to Janet Robinson, Leadership Gift Officer at sll@wlu.ca

Upon completion of the project, successful applicants must submit an accountability report outlining how the funds were used,
the benefits of the project to undergraduate students and how the gift from the Students' Union was recognized.

My project is for: * Waterloo Campus    Brantford Campus    Multi-Campus
I am a student who is applying for student-based project that is not associated with any academic department at WLU. I understand that, if my project is approved, the Students' Union will manage the funds of the project.

Project Leader
Budget Manager
Name: *
Name: *
Title: *
Email Address: *
Email Address: *
Phone Ext: *
Phone Ext: *
Project Title: *

Project Summary: *
(Please include a description of the project.)
(max 1250 characters or 250 words)

1250 characters left.
Estimated Start Date: *
Estimated End Date: *
Have you applied for any other sources of funding?
Yes, I have applied to other sources.
If yes, please provide a brief description and amount of your request (include, if possible, when you will know if you are successful)

General Enhancement of Student Life: *
(Please describe how your project will enhance undergraduate student life. In particular, your application should align with either increased opportunity for students to engage in activities leading to improved personal health & wellness or increased opportunity for undergraduate students to engage each other and their environment in a culture of learning outside of physical classroom space.)
(max 1250 characters or 250 words)

1250 characters left.
Which units/departments/faculties have you consulted/collaborated with on this project? *
Approximate number of undergraduate students that will directly benefit from this project: *

Budget Details: *
(Provide a proposed budget for the project, including all sources of revenue and expenses. Please indicate if these expenses have been quoted by a third party and ensure that HST and all related expenses are included.)

Index Number: *
(Please provide an index number where funds should be applied should your project be successful)
- 510105 (Grant - Special)
Student Life Levy Funding Request: * $

Privacy: *

Please be aware that the terms of this application may be shared with The Cord and/or posted on Wilfrid Laurier University's website.

I have read and agree to the privacy statement above

Approval: *
Applications made by academic and adminstrative departments must receive prior approval from the most senior person in your area.
My application has been approved by:


You will receive a confirmation email that your application has been received.

You will receive a second email once the committee has met advising if your application was successful.