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Western University Be Extraordinary The Campaign For Western

My Thanks: Donor Support for Students

Thank you for filling out this form to provide information to the donor who made your scholarship, award or bursary possible.

Information provided here will be sent to your donor to demonstrate the impact of providing support for Western students. Your words help donors understand the importance of their generosity.

The personal information on this form is collected under the authority of the Royal Charter of 1841, as amended. Your information will not be shared publicly. If you have any questions or concerns about the information collected or how it will be used, please contact Donor Relations and Stewardship at donorrelations@uwo.ca.

Tell Us About Yourself


Student Number:

Name of Scholarship/Award/Bursary*:

* Please copy and paste the name from the email sent to you by the Office of the Registrar and/or Alumni Relations & Development during the 2016-2017 academic year.

If you received more than one award and would like to use the same thank you letter for both, please list the names for each of them below. Otherwise please fill out a unique form for each award:

Name of 2nd Scholarship/Award/Bursary:

Name of 3rd Scholarship/Award/Bursary:


*Home Province/State or Country:

*Primary Faculty:

2nd Faculty (for dual/concurrent degrees):

Message To Your Donor

The following open-ended questions will be combined to create a thank you letter. Since your donor(s) will not see the original questions, you may want to consider reframing the questions in your responses. Please use complete sentences and aim to write at least three to five sentences per open-ended question.

How has this financial support made a difference to your Western Experience? (i.e. Allowed you to play sports, participate in clubs, volunteer, engage in experiential learning opportunities, or helped alleviate the burden of paying for school.)

What are your hopes/plans for the future and what would you like to accomplish once you complete your degree?

Please include a message of thanks to the donor(s) of your award. For example: Thank you for your generosity. This award has allowed me to fully participate in The Western Experience. I hope that one day I will make a similar impact in the life of another student.

Contact Information (optional)*

*If you choose to provide your contact information, it will only be shared with your donor(s) who may be in touch with you.

Western Email:

Phone Number (i.e. 555-555-5555):

Photo (optional)*:
*File name should include first/last name and Western student number, File size cannot exceed 2.0 MB.

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