Office of Graduate Studies
DairyFarmersofOntarioDoctoralResearch
AssistantshipApplication
_______________________ _______________________
___________________
____ _______________
________
_______________________
______________________________________________________________________________
___________________
__________ _______________________________________
_____________________________ _______________
________________________
__________________________
CurrentDegreesComple
ted
/InProgress:
List your degree and diplomas starting with the most recent or in progress.
Attach official University transcripts from each location of study. (University of Guelph transcripts are not necessary.)
Degree University Period of Study
_______________________________ _______________________________ ______________________________
_______________________________ _______________________________ ______________________________
_______________________________ _______________________________ ______________________________
_______________________________ _______________________________ ______________________________
Anticipated Start Date
(You must have submitted your online PhD application to be considered or this award.):
Proposed Area of Research:
Dept.:Proposed Supervisor:
Email:Telephone:
Complete Address:
Department/School:
Degree Program:Student ID:
First Name:Last Name:
AdditionalResea
rchExperience:
Location:
Supervisor:
Supervisor:
Supervisor:
Location:
Location:
_____________________________________________________________________________________
____________________________________ Period Covered: __________________
______________
_____________________________________________________________________________________
____________________________________ ________________________________
_____________________________________________________________________________________
____________________________________ ________________________________Period Covered:
Period Covered:
Candidates must ask two individuals to provide an assessment on their behalf. Give the name of the individuals whose
assessment accompanies this application. Sealedletterswiththereferees’signatureonthebackoftheenvelopemustbe
attached.
Name Position Held Institution/ Location
_______________________________ _______________________________ ______________________________
_______________________________ _______________________________ ______________________________
Sponsors/References
Pro
posedAreaofResearch
This section should be complete
d in collaboration with the proposed supervisor. Both the candidate and the proposed
supervisor must sign on page 4 to confirm the accuracy of the proposed training program.
_____________________________________________________________________________________
DescriptiveSummary of the research project. Include specific hypothesis of research and describe the candidate’s role
in the project. Use layman’s language. If you need more space to describe your research project, insert one additional
page immediately following this page.
Project Title:
Academican
dProfessionalExperience
Begin with your most recent (includes academic, industrial, public sector)
Position Institution/ Organization
Start Date
(mm/yyyy)
End Date
(mm/yyyy)
______________________________ _______________________________________ _________ _________
______________________________ ________________________________________ _________ _________
______________________________ ________________________________________ _________ _________
______________________________ ________________________________________ _________ _________
______________________________ ________________________________________ _________ _________
InterruptionsinScientificCareer
If there has been an interruption in pursuit of your scientific career either in or subsequent to training, provide an
explanation. List the period and reason for the interruption.
HonoursandAwards
Provide as much detail as possible on the type of award, including salary and training awards, date awarded and
awarding agency.
______________________________________________________________________________
____________________________________________ ___________________
__________________________________________________________________
____________
______________________
______________________ ___________
________
______________________________________________________________________________
____________________________________________ ___________________
______________________________________________________________________________
____________________________________________
Type of Award:
Awarding Organization:
Type of Award:
Awarding Organization:
Type of Award:
Awarding Organization:
Type of Award:
Awarding Organization:
Type of Award:
Awarding Organization:
Type of Award:
Awarding Organization:
Date Awarded:
___________________
______________________________________________________________________________
____________________________________________ Date Awarded: ___________________
___________
___________________________________________________________________
______________________
______________________ :Date Awarded ___________________
Date Awarded:
Date Awarded:
Date Awarded:
Public
ati
ons
a) Indicate the number of publications (as sole or coauthor) in
cate
gory (e
xclu
di
ng
manuscrip
ts in
progress) over the
course of you
r
career
to da
te.
Published/InPress Submitted
Refereed Research Paper
______________________________________ _______________________________
Case Reports
______________________________________ _______________________________
Book Chapters
______________________________________ _______________________________
Abstracts/ Research Papers
Provincial or National ______________________________________ ______________________ _________
Abstracts/ Research Papers
(International Meeting) ______________________________________ _______________________________
Internal Research
Presentations ______________________________________ _______________________________
Continuing Education
Presentations ______________________________________ __________________________ _____
b) List the publications and presentations in each of the categories provided in over the course of your career. Start with
the most recent. For each publication list the full authorship as it appears in the original publication, year, title, name
and volume of the publication and the first and last page numbers. For the presentation of external and internal
abstracts, and the continuing education presentations provide information on the location, meeting, audience and
date. If you need more space, you may attach an additional page.
The undersigned agree that this accurately describes the program proposed.
Proposed
Supervisor:
Candidate:
______________________________________________ ___________________
______________________________________________ ___________________
ProtectionofPrivacy:We are committed to protecting your privacy. Personal information is collected under the authority of the University of Guelph Act and
pursuant to the FreedomofInformationandProtectionofPrivacyAct(FIPPA). If you have questions about the use and disclosure of your personal information, call
the OfficeofGraduateStudiesat (519) 8244120 ext. 56833. You can also find more information about access to information and protection of privacy at the
University of Guelph from the UniversitySecretariat.
Date:
Date:
click to sign
signature
click to edit
click to sign
signature
click to edit
Chrome Web Store
It looks like you haven't installed the Fill Chrome Extension Add to Chrome