MANITOBA PUBLIC INSURANCE OCCUPATIONAL THERAPY and PHYSICAL THERAPY TUITION SCHOLARSHIPS

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1 MANITOBA PUBLIC INSURANCE OCCUPATIONAL THERAPY and PHYSICAL THERAPY TUITION SCHOLARSHIPS Eligibility: OT2 or PT2 Deadline for Submission of Application: September 30 Manitoba Public Insurance offers annual scholarships for students in the Master of Occupational Therapy and Master of Physical Therapy Programs at the University of Manitoba. The purpose of the Scholarships is to support Manitoba students who demonstrate potential for leadership in work related assessment and rehabilitation services, return to work and / or ergonomics in the field of Occupational Therapy and to promote Occupational Therapy careers as a growing area within the corporation s Health Care Services department. Up to four scholarships, valued at $2,500 each, will be awarded to successful candidates. Criteria for Application: For graduate students in the Master of Occupational Therapy (MOT) program to be eligible for this scholarship they must: 1) be a resident of Manitoba; 2) be enrolled full-time in the Faculty of Graduate Studies in the final year of study in the Master of Occupational Therapy (MOT) program offered by the School of Medical Rehabilitation at the University of Manitoba; 3) have maintained a minimum degree grade point average of 3.75, with no grade lower than C+, throughout the MOT program; 4) have achieved a minimum grade of B+ (or equivalent) in each of the following courses: (i) OT 6130 Occupational Therapy Practice Skills I a. OT 6300 Occupational Analysis and Adaptation b. OT 6310 The Environment and Occupational Performance c. OT 6330 Occupational Therapy Practice Skills 2; 5) have demonstrated leadership qualities within the Department of Occupational Therapy and through community involvement; 6) have demonstrated interest in furthering their learning through participation in professional development activities. For graduate students in the Master of Physical Therapy (MPT) program to be eligible for this scholarship they must: 1) be a resident of Manitoba; 2) be enrolled full-time in the Faculty of Graduate Studies in the final year of study in the Master of Physical Therapy (MPT) program offered by the School of Medical Rehabilitation at the University of Manitoba; 3) have maintained a minimum degree grade point average of 3.75, with no grade lower than C+, throughout the MPT program; 4) have achieved a minimum grade of B+ (or equivalent) in each of the following courses: a. PT 6250 Integrated Practice for Neuromusculoskeletal Conditions b. PT 6260 Physiotherapy Practice and Professional Issue I - 1 -

2 c. PT 6221 Clinical Skills for Neuromusculoskeletal Conditions I d. PT 6222 Clinical Skills for Neuromusculoskeletal Conditions II 5) have demonstrated leadership qualities within the Department of Physical Therapy and through community involvement; 6) have demonstrated interest in furthering their learning through participation in professional development activities. Applicants will be required to submit the following typed documents: Manitoba Public Insurance Occupational Therapy and Physical Therapy Tuition Scholarship Application form (typed) Current academic web transcript(s); Curriculum vitae (typed, 12pt font, double-spaced); One letter of recommendation from an Occupational Therapist or Physical Therapist (a faculty member or practitioner); Application deadline: September 30 Recipients will be required, upon completion of their studies, to provide a brief report (maximum 150 words), a photograph (if available), and a short biography to be used by Manitoba Public Insurance in publicity related to the Scholarships. Recipients may hold the Manitoba Public Insurance Occupational Therapy and Physical Therapy Tuition Scholarships concurrently with other awards, consistent with policies in the Faculty of Graduate Studies. The award will be applied to tuition fees incurred in the second semester of the academic year in which the award is tenable. The selection committee will be named by the Dean of the Faculty of Graduate Studies (designate). University of Manitoba representatives (faculty and/or staff) must constitute at least 50 percent of the selection committee and Manitoba Public Insurance representatives will constitute a portion of the selection committee. To apply submit this application, and all associated documentation, to the College of Rehabilitation Sciences at: Awards Chair: - 2 -

3 OCCUPATIONAL THERAPY and PHYSICAL THERAPY TUITION SCHOLARSHIPS APPLICATION FORM PART I: STUDENT APPLICANT INFORMATION NAME: *** Expand your answer as necessary. The answer boxes below do not indicate how much you can write *** ADDRESS: CITY: TELEPHONE: (HOME) PROGRAM: STUDENT NUMBER: PROVINCE & POSTAL CODE: TELEPHONE: (CELL) YEAR IN PROGRAM: PROFESSIONAL MEMBERSHIP: Canadian Association of Occupational Therapists Membership #: Canadian Physiotherapy Association Membership #: ACADEMIC PERFORMANCE: Overall GPA during enrollment in first year of Occupational Therapy: Overall GPA during enrollment in first year of Physical Therapy: REQUIRED COURSES GPA: Course OT 6130 Occupational Therapy Practice Skills 1 OT 6300 Occupational Analysis and Adaptation OT 6310 The Environment and Occupational Performance OT 6330 Occupational Therapy Practice Skills 2 Course PT 6250 Integrated Practice for Neuromusculoskeletal Conditions PT 6260 Physiotherapy Practice and Professional Issue I PT 6221 Clinical Skills for Neuromusculoskeletal Conditions I PT 6222 Clinical Skills for Neuromusculoskeletal Conditions II GPA GPA - 3 -

4 EVIDENCE OF OCCUPATIONAL THERAPY or PHYSICAL THERAPY STUDENT SERVICE (can include student placements as part of studies): Organization/Agency/Institution Dates Number of hours volunteered EVIDENCE OF STUDENT LEADERSHIP: Position/Organization/Group Role Dates Number of hours volunteered PROFESSIONAL DEVELOPMENT: (List additional professional development activities undertaken) ACADEMIC HONORS: (List any grants, scholarships and/or awards you have received). WHAT MAKES YOU A GOOD CANDIDATE FOR THE MANITOBA PUBLIC INSURANCE TUITION SCHOLARSHIPS? - 4 -

5 A letter of intent (maximum 1,000 words) describing how (i) their involvement in service and leadership roles, within the Department of Occupational Therapy or the Department of Physical Therapy and in the broader community, has impacted their studies; and (ii) their profession's role in return to work or daily functional activities, rehabilitation planning and services, ergonomics and or functional training

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9 OCCUPATIONAL THERAPY and PHYSICAL THERAPY TUITION SCHOLARSHIPS APPLICATION FORM PART II: INSTRUCTIONS TO STUDENTS REGARDING REQUIRED LETTER OF SUPPORT FROM REFEREE Referee Name Address Area of expertise years known Association (faculty member or practitioner) Only one letter of support may be included with your application form. Additional letters will not be sent to the Awards Committee. Instructions to students: Provide a copy of your completed application to your referee. Provide your referee with the instructions below and the original of Part II below, or refer them to the online form at umanitoba.ca/faculties/medicine/units/medrehab/awards.html Allow sufficient time to enable your referee to complete and submit the form. The referee must submit the form and the letter of reference directly to the College of Rehabilitation Sciences: Attn: Awards Chair, College of Rehabilitation Sciences Application deadline is: September

10 OCCUPATIONAL THERAPY and PHYSICAL THERAPY TUITION SCHOLARSHIPS APPLICATION FORM PART II: INSTRUCTIONS TO REFEREE ON HOW TO COMPLETE PART II OF THE MPI APPLICATION Who should complete this form? Complete this form if you have agreed to evaluate an applicant for an MPI award. Use this form in conjunction with the applicant s completed copy of the MPI application form Once you have completed the rating form and have attached a letter of support, the Awards Committee will use it to review and assess the application for an award. Complete and submit the signed form and the letter of support prior to the deadline (September 30). The Awards Committee will not consider the application without it. How to complete this form Rate the applicant on each of the evaluation criteria in the grid and justify your evaluation in the supporting letter. Rather than providing general comments, assess the applicant s strengths and limitations for each criterion. Include specific examples of the applicant s accomplishments and contributions to support your assessment. Note: If you provide exceptionally high or low ratings that are inconsistent with the application as a whole, they may diminish the report s credibility. Please note that this report will be accessible to the applicant with your particulars blocked out. General Presentation When you prepare your report on the applicant, follow these guidelines: The form and letter of support must be typed and submitted electronically; The letter must be in 12 pt. font; Condensed type is not acceptable; and A one-page letter of support must be appended (this letter should be consistent with the ratings provided in the grid) Application deadline is: September 30 Submit to:

11 OCCUPATIONAL THERAPY and PHYSICAL THERAPY TUITION SCHOLARSHIPS PART II: TO BE COMPLETED BY REFEREE This report is CONFIDENTIAL and must be completed by a faculty member from any academic institution or an Occupational Therapist or Physical Therapist practitioner with special knowledge of the student LAST NAME OF APPLICANT FIRST NAME THIS REPORT CONSISTS OF THREE PARTS AND ALL PARTS MUST BE COMPLETED: The information provided on this form is most important to the Award Committee in evaluating the suitability of the candidate for receiving the MPI award. You are therefore asked to give detailed information (both pros and cons) about the candidate. (2.1) How long have you known the student and in what capacity? (professor, fieldwork educator etc.) (2.2) Check the boxes that most nearly represent your opinion of the candidate in comparison with a representative group of individuals you have known who have had approximately the same training and experience. (2.3) The letter of support should be typed in black, as the material must be duplicated for the peer review process. 2.1 HOW LONG HAVE YOU KNOWN THE STUDENT AND IN WHAT CAPACITY? I have known this applicant for (#) years in the capacity as his/her (professor, fieldwork educator, etc.) On the basis of my experience with (#) students at a similar level over years, I would give this student the following rating: 2.2 RATING FORM (Note: Ratings should be consistent with information contained within the body of the application form including the marks on the transcripts). UNABLE TO JUDGE EXCEPTIONAL EXCELLENT VERY GOOD GOOD ACCEPTABLE Upper Upper 10% Upper 15% Upper 20% Upper 33% Upper 50% Lower 50% 2% Academic Preparation Demonstrated Scholarly Ability Demonstrated Clinical Ability Communicatio n Skills (written) Communicatio n Skills (oral) Industriousness / Motivation Creativity Originality Judgment 2.3 PLEASE ELABORATE ON THE ABOVE RATINGS BY ATTACHING AN ADDITIONAL LETTER OF SUPPORT (REQUIRED) Name of Respondent (Print) Date Position Institution

12 OCCUPATIONAL THERAPY and PHYSICAL THERAPY TUITION SCHOLARSHIPS APPLICATION FORM PART III: OPTIONAL RELEASE OF INFORMATION (TO BE COMPLETED BY APPLICANT) Manitoba Public Insurance would like to post the names of the scholarship winners on its website. Please indicate below if you agree to have your name posted should you receive a scholarship. Whether or not you agree to have your name posted does not affect the scholarship selection process. If you consent, please initial: If I receive a Manitoba Public Insurance Tuition Scholarship, permission is granted to post my name on the corporation s website. SCHOLARSHIP RESPONSIBILITIES: I have read the recipient responsibilities connected to the Manitoba Public Insurance Tuition Scholarships and agree to meet them. Applicant Signature Date My signature indicates that I personally have completed the application and that the information provided is complete and truthful. Applicant Signature Date

13 OCCUPATIONAL THERAPY and PHYSICAL THERAPY TUITION SCHOLARSHIPS APPLICATION FORM PART IV: CHECKLIST Applicant name: CHECKLIST: Academic information: Completed Manitoba Public Insurance Occupational Therapy and Physical Therapy scholarships application form Current academic transcripts (web transcript accepted) including graduate courses to date, if available Letter of recommendation from an Occupational Therapist or Physical Therapist (to be sent to us by them) Career Goals Associated with Manitoba Public Insurance Areas of Interest: Curriculum Vitae To apply submit complete application package to the College of Rehabilitation Sciences at: Awards Chair:

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