Operating Grant Fund Application Form

• Transfer of Signing Authorities for DGSAs •

For technical issues with the form please contact internal@yugsa.ca

For inquiries regarding funding or required documents please contact finance@yugsa.ca

This form is the be completed only by the primary executive of Departmental GSAs currently registered with the YUGSA.

Association Information

Association's Name (Full Name)*

Graduate Program*

Graduate Program (if not listed)

York U Campus*

Campus Building / Room #*

Primary Executive Info as Registered with the YUGSA

First Name:*

Last Name*

Position:*

Phone Number:*

E-mail:*

Acknowledgement

By signing, you are acknowleging that you are authorized on behalf of your Departmental GSA to declare the following signing authority transfers.

Signature (Use mouse, or touch/pen on tablets)

Date*

Date

Sigining Authority Transfers

Banking Information

Select Your Financial Institution*

Financial Institution's Name (If not listed)

Name of Account *

Account Number*

Account Type*

ChequingSavingsCredit Card

Please provide the full names of all of your previous signing authorities in your DGSA.*

Please indicate the signing authorities of your DGSAs for this year in the fields below.

[1] Full Name*

Position*

Phone Number*

E-mail*

[2] Full Name

Position

Phone Number

E-mail

[3] Full Name

Position

Phone Number

E-mail

You will be contacted by our VP Finance or Finance Coordinator when your letter is ready. The letter may only be picked up by the primary executive (identification required).