NSERC CREATE: STEWARDApplication Form

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NSERC CREATE: STEWARDUndergraduate Application Form

please use only single spaced, 11 point non-condensed font for all sections

Use only blank space provided in application form sections

Applicant Information
Family Name / Given Name / Initial(s) / Date of Birth
Institution (Dalhousie or Queen’s University) / Student Number
Current Address / Permanent Address (if different than current)
Street Address / Street Address
City / Province / Post Code / City / Province / Post Code
Telephone No. / Fax No / Email address (will be used as initial point of contact)
Citizenship (please indicate your answer with an ‘ X’)
[ ] Canadian Citizen / [ ]Permanent Resident / [ ] Other / Country of Citizenship: ______
[ ] Student Visa / [ ]Study Permit
Program Related
Start Date:
Month [ ] Year [ ] / Current Year of Study:
[ ]
Proposed Supervisor(s)
Name / Research Address
1.
2.
Please note: You and your supervisor/s will be notified of the results of this competition.
Transcripts
Transcripts must be sent from issuing institution – official transcripts only. They must be delivered to the Centre For Water Resources Studies unopened and bearing the institution’s seal. Subject to same deadline as application. If up to Date transcripts have already been submitted as part of an application to enrol in graduate school at Dalhousie, the student can request for us to use these.
Curriculum Vitae
Please provide a CV (separate document) that includes the following:
  • All publications -include thesis title & status (in progress /completed)
  • Relevant distinctions and awards received
Any other relevant experience
Signature
I hereby certify that all of the above information and all information on supporting documents are correct and complete. I agree that any award made to me as a result of this application will be subject to the general conditions governing NSERC scholarships, the STEWARD Create Program, and Dalhousie University including any revisions, deletions or additions made to them in the future.
Applicant’s Signature / Date
SUPERVISOR(S) SIGNATURE (S)
Signature of Supervisor / Date
Signature of Supervisor / Date
APPENDIX C – NSERC CREATE AGREEMENT
Agreement
If awarded an NSERC CREATE training award, I agree to fulfill the requirements of the program as described in Program requirements detailed in the application.
______
Student Name (PRINT)
______
Signature
______
Date
Please send completed application form:
Email / Postal Mail
Wendy Krkosek
Program Coordinator, NSERC CREATE: STEWARD

Note: Please submit entire application package through email as one PDF file.
* Unopened Reference letters should be mailed by post separately. / Wendy Krkosek
Centre for Water Resources StudiesDalhousie University
1360 Barrington Street D508
PO Box 15000
Halifax NS B3H 4R2