Deadline for submission to Faculty of Graduate Studies, Laurentian University: January 31 st 2018

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Faculty of Graduate Studies Tel/Tél.: 705-675-1151, 3210 2018-2019 Application Checklist Faculté des études supérieures Fax/Téléc. : 705-671-3840 935 Ramsey Lake Rd, Sudbury, ON P3E 2C6 The OGS program is jointly funded by the province of Ontario and Ontario Universities. Please check off each item that you have included in your OGS Application Package in order to ensure that all documentation is provided. Print, sign and date your application and submit to the Faculty of Graduate Studies. This scholarship is not transferable to any other institution and must be held at Laurentian University. Last name: First name: Student number: Proposed program : Deadline for submission to Faculty of Graduate Studies, Laurentian University: January 31 st 2018 OGS Application Package Please verify that the following items are accounted for in your application. Student Checklist Application checklist OGS Application form signed and dated by student Academic Assessment Report # 1 Academic Assessment Report # 2 Transcripts (Provide grades from all postsecondary institutions you have attended up until Aug. 31 st /2016.) Laurentian University students do not need to order an LU transcript. Grades will be tallied by the Faculty of Graduate Studies and forwarded to the program coordinator. Proof of citizenship (Only required for International students) Statement of Interest (Master s students only 1 page maximum) Plan of Study (Doctoral students only 2 pages maximum) Optional items List of Publications and Presentations (1 page maximum) List of Other Scholarships and Awards (1 page maximum) List of Significant Academic Accomplishments (1 page maximum) Student signature: X Date: Office use only Average /100 Page 1 of 11

Application Form Personal Information: Date of birth: Year/Month/Day Laurentian student # (if applicable): Permanent Canadian Mailing Address: Street name and number, rural route, or post office box: Apartment: City, town or post office: Province: Postal Code: Area code and telephone number: Email address: Your citizenship status: Canadian Citizen Temporary Resident Visa/Study permit Permanent Resident Protected Person Aboriginal * If you selected Permanent Resident, Protected Person or Student Visa, please provide a copy of your valid student visa and/or study permit. * For the purposes of the scholarship, an Aboriginal person is a person who self-identifies as a First Nations (Status/Non-Status), Métis or Inuit. Page 2 of 11

Application Form Current Status: 1. Are you currently enrolled at Laurentian University? Yes No If no, which institution are you currently attending? Faculty: Program: 2. What is your current level of studies? Doctorate Master s Bachelor s Certificate/Diploma/Other Proposed studies at Laurentian University: Choose one program only! Faculty: Program: Proposed level of study for 2017-2018: Master s first year Master s second year Doctorate Date you expect to begin your proposed studies: Page 3 of 11

Application Form Previous studies: Please provide information on all of your previous studies. Start with your most recent studies. Include both studies done in Canada as well as in other countries. If you have additional studies, please provide the information below on a separate sheet and include it in your OGS Application Package. Have you previously attended a postsecondary institution? Yes No If Yes, please fill out the study period information below. First Study Period: Name of the postsecondary institution: Time period you attended institution: Month Year to Month Year Program name: Level of Study: Bachelor s Master s Doctorate Certificate/Diploma/Other Did you receive a degree? Yes No If Yes, date you received Month Year the degree: Second Study Period: Name of the postsecondary institution: Time period you attended institution: Month Year to Month Year Program name: Level of Study: Bachelor s Master s Doctorate Certificate/Diploma/Other Did you receive a degree? Yes No If Yes, date you received Month Year the degree: Page 4 of 11

Application Form Previous OGS and Other Awards: One of the eligibility requirements for OGS is that you must not have exceeded the lifetime maximum of 6 years of government-funded student awards. Please indicate if you have ever been in receipt of any of the following awards: Social Sciences and Humanities Research Yes No if Yes, number of years you held the Council of Canada (SSHRC) Natural Sciences and Engineering Research Yes No if Yes, number of years you held the Council (NSERC) Canadian Institute of Health Research (CIHR) Yes No if Yes, number of years you held the Ontario Graduate Scholarship (OGS) Yes No if Yes, number of years you held the Queen Elizabeth II Graduate Scholarship Yes No if Yes, number of years you held the in Science and Technology (QEII-GSST) Ontario Trillium Scholarships Yes No if Yes, number of years you held the Vanier Canada Graduate Scholarship Yes No if Yes, number of years you held the This information is collected under the authority of the Laurentian University Act, 1960. The information is used for academic and administrative purposes for the Faculty of Graduate Studies including, but not limited to, scholarship applications and administration of scholarships. The Faculty of Graduate Studies will disclose your personal information to another Department or Unit within the University as necessary and appropriate and for the purposes outline above. The personal student information will not be used or disclosed for any unrelated purposes without the consent of the student. This information is protected and being collected pursuant to section 39(2) and section 42 of the Freedom of Information and Protection of Privacy Act of Ontario (RSO 1990). Page 5 of 11

GRADUATE SCHOLARSHIP PROGRAM 2018-2019 ONTARIO Statement of Interest (Master s) N.B.: One page only, single spaced, 12 point Times New Roman font, ½ margins. Page 6 of 11

N.B.: Two pages maximum, single spaced, 12 point Times New Roman font, ½ margins. 2018-2019 Plan of Study (Doctorate) Page 7 of 11

N.B.: Two pages maximum, single spaced, 12 point Times New Roman font, ½ margins. 2018-2019 Plan of Study (Doctorate) Page 8 of 11

Publications/Presentations (optional) List all publications, presentations, posters or other significant work submitted to an external organization. List these works in the referencing style of your discipline. N.B.: One page only, single spaced, 12 point Times New Roman font, ½ margins. Page 9 of 11

Scholarships and Awards (optional) Awards and Prizes: List a maximum of 8 scholarships, fellowships, prizes and other academic or professional awards you have received and think would be most pertinent to the adjudication of your application (do not include website links) Name Source Year awarded Duration (months) Value Page 10 of 11

N.B.: One page only, single spaced, 12 point Times New Roman font, ½ margins. 2018-2019 Significant Academic Accomplishments (optional) Page 11 of 11