Global Health Travel Award Application 2022/23

This form is provided to outline the available resources and expense estimate for planned international travel as part of the GH 4300 Global Health Practicum. Budgeting is key to ensuring students are able to meet the financial requirements for a positive international experience. Each field is intended to support students in their preparation for departure and responses are not evaluated to determine funding eligibility. This application accompanies the "Cost of Living Worksheet".

General Information
Name Name * First Last
Student Number *
Preferred Email *
Planned Travel Start Date Planned Travel Start Date * / MM / DD YYYY
Planned Travel End Date Planned Travel End Date * / MM / DD YYYY

*If you intend to travel for personal reasons beyond the date of the practicum, please only provide the travel end date for the duration of your practicum.
Practicum Partner Name *
Practicum Location (City/Town) *
Practicum Location (Country) *
Available Financial Resources

Please describe available financial resources relating to participation in this practicum. Please indicate amounts in Canadian Dollars. If there is no amount for any item, please enter 0.
Note: Availability of financial resources does not preclude applicants from receiving the global health travel award.
Personal Savings * $ Dollars . Cents
Parental/Family Contributions * $ Dollars . Cents
Scholarships/Bursaries (awarded) * $ Dollars . Cents
Scholarships/Bursaries (applied & pending) * $ Dollars . Cents
Provide details of each scholarship and bursary from the previous two questions. If you have not applied for scholarship or bursary, answer N/A. *
Are you receiving OSAP? *

Are you receiving OSAP? Yes No
Estimated Expenses

Please provide estimated costs in Canadian dollars for each of the items below for the entire duration of the practicum period. If there is no cost anticipated, please enter 0.
Visas * $ Dollars . Cents
Some countries may require additional entry level requirements such as work permits or COVID entry costs. Please check with the consulate for your destination about requirements and costs.
International Flights * $ Dollars . Cents
Budget should reflect economy fares for a returning trip. Include domestic flights if required to reach practicum site from international airport. Additional airfare expenses for leisure or extended travel should not be included here.
Accommodations * $ Dollars . Cents
Please indicate what type of accommodations largely account for this expense item *
Ground or Domestic Transportation while at practicum location * $ Dollars . Cents
Include commuting transportation, train, taxi,
and domestic flights required as part of the practicum.
Internet and Phone * $ Dollars . Cents
Include cost of international phone packages, local sim cards and data plans.
Travel/Health Insurance * $ Dollars . Cents
York Students traveling abroad for international programs are required to purchase guard.me® insurance. Visit www.guard.me/yorkinternational for quotations and to purchase appropriate coverage.
Health Related Expenses * $ Dollars . Cents
Costs may include travel clinic costs, vaccines, prophylactic drugs(prescription & over the counter)
Meals * $ Dollars . Cents
Entertainment/ leisure activities * $ Dollars . Cents
Sundries * $ Dollars . Cents
Depending on practicum location, consider mosquito nets, bug repellent, sun screen, water filters, 1st aid kit, vulnerable sector screening (if required by agency)
Other Expenses $ Dollars . Cents
Please describe any other expenses budgeted. If there are none, answer N/A. *

Global Health Travel Award Application 2022/23

Global Health Travel Award Application 2022/23

General Information

Available Financial Resources

Estimated Expenses