International Internships Energy/Digital/Aerospace Scholarship application IDENTITY OF THE APPLICANT APPLICATION FORM 2016-2017 Surname Given name Date of birth : Sex : F M. year / month / day ADDRESS Mailing address Permanent address PIN Civic number/ Street Civic number/ Street City City Province/Stat Country Postal code Telephone E-mail Work PROJECT TITLE Extension Province/Stat Country Postal code Telephone The FRQNT affirms its commitment to research that meets the highest standards of ethics and scientific integrity, and works to promote good practices in research. The FRQNT suggests that you take a few moments to consider the ethical implications and scientific integrity of your research project. We invite you to: Reflect on any ethical concerns which could be raised by the objectives, methodology or anticipated outcome of your research project; E-mail Familiarize yourself with the FRQNT s policy on ethics and scientific integrity and that of your institution. AREA PLACE OF TENURE PROPOSED DOCTORAL PROGRAM IN QUÉBEC FOR SCHOLARSHIP YOU ARE REQUESTING Degree sought : Discipline : Specialization (where applicable) : Department : Name of university : City : Country : First registration in the program for which You are requesting this scholarship year / month Duration of the funded studies Start : End: ( The funded studies must have a minimum duration of 6 months and a maximum of 12 months) 1 Energy Digital Aerospace Bavaria in Germany Georgia, US São Paulo, Brazil Shandong China Upper Austria, Austria Western Cape, South Africa Institution where you will use the scholarship: Expected date of program completion : year / month
UNIVERSITY RECORD University studies Indicate all university-level studies whether completed or not, including those currently underway. Degree title Discipline Institution Registration in the research program year / month Expected or actual date on which you will obtain diploma year / month Cumulative average Scholarships or prizes obtained Indicate all scholarships or prizes obtained. Funding organizations Scholarships or prizes obtained in competitions (yes/no) Amount obtained Start of scholarship or date obtained (year/month) End of scholarship (year/month) 2
AREA, RESEARCH TOPIC AND FIELD OF APPLICATION A) In which research area of the Fonds de recherche du Québec - Nature et technologies are you applying? B) By order of importance, identify the topics covered by the research in your application (maximum of two subjects). 1. 2. C) Which field of application match the research activities in your application (maximum of two choices)? 1. 2. D) Mark 6 key-words, from the most general to the most specific, that best describe the research activities in your application. 3
JUSTIFICATION FOR APPLICATION AND AREAS OF INTEREST IN RESEARCH Explain why you want to complete graduate studies in this field and justify your choice of university, and supervisor. Describe your areas of interest in research. 4
SKILLS AND EXPERIENCE a) Publications List, beginning with the most recent, refereed publications such as papers, conference summaries, proceedings, published books or chapters of published books. Submitted papers will be considered only when a copy of the publisher's acknowledgment of receipt is provided. Papers accepted for publication must include the publisher's notice. Mark peer-reviewed publications with an asterisk. Where applicable, indicate specific departmental policies concerning publications. Submitted articles may be considered only if accompanied by a copy of acknowledgement from the editor, and articles accepted for publication must be accompanied by notification from the editor (acknowledgments of receipt are not required for published articles). Pending articles are not taken into account if they have not been submitted. b) Participation in research projects and training periods Describe your participation in research projects and training periods during your previous studies. Identify project directors and training periods; give the starting and final dates of the activity. You may also indicate any relevant experience that could contribute to your successful completion of the program in question. c) Other relevant information for evaluation of your application Mention all relevant information for evaluation of your application and specify, where applicable, the circumstances that may have delayed your studies: work, part-time studies, sick leave, maternity leave, etc. a) Publications (1); conferences (2); other contributions (3) (one page). b) Participation in research projects and training periods (one page). c) Other relevant information for evaluation of your application (half a page). 5
SKILLS AND EXPERIENCE (continued) 6
SKILLS AND EXPERIENCE (continued) 7
SKILLS AND EXPERIENCE (continued and end of section) No appendix will be accepted SOCIAL IMPLICATION, LEADERSHIP AND COMMUNICATION SKILLS Mention all which can demonstrate your social implication, your leadership and your communication skills. No appendix will be accepted 8
DESCRIPTION OF RESEARCH PROJECT Clearly describe your research project by specifying in the following order: a) the problem; b) research objectives; c) methodology. (maximum one page). No appendix will be accepted 9
DESCRIPTION OF RESEARCH PROJECT (continued and end of section) Contribution to the advancement of knowledge and bibliography. Mention the contribution of the project to the advancement of science and present a bibliography (3 to 5 key publications). (maximum half a page). No appendix will be accepted 10
REQUIRED DOCUMENTS PART 1 1- An invitation letter from the foreign host institution; 2- Acknowledgements of receipt from the editor for all articles submitted and notices received from editors for articles accepted for publication (acknowledgements of receipt for articles already published will not be sent to the evaluation committee); 3- An official transcript (an unofficial electronic version will not be accepted) for all university studies, completed or not (certificate, degree, Bachelor s, Master s, PhD. etc); 4- Permanent residents must provide a copy of their Record of Landing or permanent resident card; 5- Applicants who are not Canadian citizens or permanent residents of Canada must provide a copy of their Québec study permit; 6- Canadian citizens born outside must provide a copy of proof of Canadian citizenship; 7- A photocopy of a valid Quebec medical insurance card or any other document which proves that the applicant is a resident of Québec within the meaning of the Québec Health Insurance Act. 11
International Internships Energy/Digital/Aerospace Notice of deposit (available in French only) APPLICATION FORM 2016-2017 This filling notice is a document attesting that an online application has been forwarded via the Internet to the Fonds. It becomes available for printing only after having transmitted your electronic form. IDENTITY OF THE APPLICANT Surname Given name PIN No de dossier, code or matricule Program Committee : (1 to14) A to G UNIVERSITY RECORD Degree title Discipline Institution Registration in the research program Year / month Expected or actual date on which you will obtain diploma year / month Cumulative average PROPOSED DOCTORAL PROGRAM FOR THE SCHOLARSHIP YOU ARE REQUESTING Degree soughy : Discipline : Specialization (where applicable) : Department : Name of university : First registration in the program for which you are requesting this scholarship : year / month Duration of the funded studies Start : End : 12