Experiential Learning Project Fund Application Form (ELPF 2017-2018)

Experiential Learning Project Fund Application Form (ELPF 2017-2018)

Experiential Learning Project Fund Application Form (ELPF 2017-2018)

Thank you for your interest in the Experiential Learning Project Fund (ELPF)! The ELPF provides funding to create new for-credit and co-curricular experiential learning opportunities/roles for graduate and undergraduate students at Queen’s University. The goal is to increase capacity for Experiential Learning (EL) activities and allow students to apply workplace-linked skills and knowledge to specific projects that can help prepare them for their future transition to employment.


a)Review the criteria on the ELPF website.

b)Complete the application below.

c)Save the application as a PDF or word document as follows: ELPF_ProjectName_Year

d)Complete the ELPF Budget Form (available on the ELPF website) in MS Excel and save as: ELPFBudget_ProjectName_Year

e)Email with BOTH the ELPF Application and ELPF Budget Form attached. Put “ELPF Application and Budget” in the subject line.


  1. Title of EL opportunity:
  1. Start date of EL opportunity:
  1. End Date of EL opportunity:
  1. Contact details of individual submitting application:


Phone Number:


Student/Employee Number:

Net ID:

For curricular-based EL opportunities:

Course Name/Number:



For co-curricular-based EL opportunities:

Group or Club Name:

Sanctioning Body (i.e. AMS, Faculty):

  1. If applicable) If you are applying as an individual student to create a new EL opportunity for yourself, please explain how this funding will assist you in overcoming barriers to EL participation due to circumstances such as a disability, socio-economic status, or family responsibilities.
  1. Provide a short description of your EL project (max 100 words). Please indicate if you are working with a community partner.
  1. Use the Checklist below to identify the type of EL project you are creating

☐Organizing a conference

☐Organizing a competition (e.g. hackathon)

☐Community service project

☐Artistic performance

☐Specific field experience directly related to students’ field of study

☐Industry-related boot camp

☐Industry-related innovation project

☐Public awareness campaign

☐Other: ______

  1. Please complete the chart below to list and briefly describe each type of EL role you will be creating with this funding. Please provide the total number of roles being created. Preference will be given to projects that provide EL roles for 5 or more students; roles should create opportunities for students to practice authentic work-related skills that will improve their employability, interpersonal skills and transition to the workforce. Note: “attendees” and “participants” are not considered to be EL roles for this fund.

Example EL Roles

EL Role / Description / Total Number of Hours / Total Number of Roles
Project Coordinator / Define project goals; create work plans; delegate tasks; make decisions; / 40 / 1
Communication Coordinator / Lead contact with community partner; create communication plan for event promotion; coordination project team communication / 40 / 1
Event Volunteers / Liaise with community partner; execute event plan; communicate with event participants; / 5 / 4

EL Roles

EL Role / Description / Total Number of Hours / Total Number of Roles
  1. Use the checklist below to identify the student learning outcomes and skills development associated with your EL Project.

☐Leadership: Take initiative by providing vision, motivation, and action; Guided by principles of integrity, social responsibility and an ethic of care

Written & Oral Communication: Express ideas clearly and convincingly using a variety of methods

☐Self-Management: Manage and evaluate own learning, behaviour, well-being and values while practicing ethical decision-making

☐Collaboration: Make meaningful contributions in a group environment with a positive manner of interaction

Critical Thinking: Provide informed and innovation conclusions, judgements or solutions while recognizing need for ongoing learning and limits of knowledge

Inquiry and Analysis: Engage in learning and discovery; Transfer knowledge and skills to new situations, experiences and environments

☐Adaptability: Open and respond constructively to feedback; Learn from mistakes; Manage/cope with uncertainty

☐Time Management: Plan and manage time (and other resources) to achieve goals; Set appropriate and achievable goals & priorities

Civic Engagement and Global Learning: Students make a difference in their communities, both locally and globally

Intercultural Competence: Students develop skills and attributes that support effective and appropriate interaction in diverse cultural contexts

☐Other: ______

  1. Use the checklist below to indicate which tools and resources you will use to support student learning. (The EL Hub will be happy to assist you in identifying and/or developing tools for your project should you require assistance.)

Check all that apply

  1. Training and preparation:

☐Pre-departure workshop or online training

☐Learning plan

☐Course assignment

☐Background reading

☐Student-employer learning contract

☐Other: ______

  1. Opportunities for student reflection and self-assessment

☐Self-reflection form

☐In-class reflective seminar or workshop

☐Online discussion forum

☐Employer performance evaluations

☐One-on-one meetings with an instructor, supervisor or student leader

☐Other: ______

  1. Evaluation/synthesis of student learning outcomes

☐Final reflective course assignment

☐Post-experience debrief

☐Brief Summary of learning/skills and future recommendations

☐Public engagement (i.e. presentation)

☐Other: ______

  1. Will these new EL opportunities support underrepresented student populations and communities?


Please explain how: ______


  1. Where will the EL opportunity take place?

☐Canada (Province: ______City/Community: ______)

☐Outside of Canada (please list which country :______)


As previously noted above, you are required to submit the ELPF Budget Form with the completed ELPFApplication Form.

  1. What is the estimated total cost of creating these new EL opportunities?
  1. How much funding are you requesting from the ELPF?
  1. Do you already have a source of funding over $10,000 toward this project? (Priority will be given to projects that do not have other significant sources of funding.)