TRAINING MODULE CANDIDATE LOCATION WHERE RESEARCH WILL BE CONDUCTED. Descriptors: (Provide up to 10 keywords to describe this research project)



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Nasivvik Centre for Inuit health and changing environments TRAINING MODULE CANDIDATE Surname Given Names Citizenship: Canadian Permanent Resident Other: Proposed Program Start Date : Program Competition Date (DD/MM/YYYY): Have you applied to this program in the last two years? Yes No 1 Primary Supervisor: Surname Given Names 2 Co-Supervisor (if applicable): Surname Given Names LOCATION WHERE RESEARCH WILL BE CONDUCTED Institution / Organization Department Faculty / School Institution which will administer the funds Period of support requested: Years Months Language in which proposal is written: English French Descriptors: (Provide up to 10 keywords to describe this research project) PROJECT TITLE SIGNATURES Candidate Primary Supervisor Co-Supervisor (if applicable) Name: Name: Date: Date: Training Module, Page 1, (01/2010)

DEGREE IN PROGRESS Degree Type Degree Name Department Institution Start date Expected date of completion Qualifications, certificates and licenses in progress Start date Expected date of completion With this award, are you proceeding or planning to proceed to any additional degree, diploma, specialty certification? No Yes (please specify) DEGREE SOUGHT Degree Type Degree Name Department Institution Start date Expected date of completion SPONSORS It is the responsibility of the candidate to ensure that their sponsors complete the appropriate assessment form (fillable PDF version is required). Candidates must have three individuals provide assessments on their behalf. Additional assessments will not be considered. These should include (if applicable) assessments from each of the candidate s two most recent research supervisors. List the names of the individuals whose assessments accompany this application below. Name of Sponsor / Relationship to Candidate Current Position Held Institution 1. 2. 3. Training Module, Page 2, (01/2010)

TRAINING EXPECTATIONS This section consists of text to be attached to the application. Attached documents may be prepared in the word processing software package of your choice, printed and inserted in the application form. Follow these guidelines to prepare your attached documents: At the top of each page, indicate your name and the title of the section. (e.g., Training Expectations) At the bottom of each page clearly indicate the page number. (e.g., 3a, 3b) The details and / or instructions must be printed on the first page of each document (these instructions can be copied and pasted from this page and printed in smaller print - they must be legible). Insert a margin of 2 cm (3/4 inch) - minimum - around the page. Use a font size of 12 point, black ink. Six lines per inch. No condensed type or spacing. Text to be attached 1. Master's and Doctoral Research Award Candidates: Provide an overview describing how the training you expect to acquire will contribute to your productivity and to the research goals you hope to achieve. (Maximum two pages) Training Module, Page 3, (01/2010)

Lay title of research (one line only) ABSTRACT (SUITABLE FOR PREPARATION OF A PRESS RELEASE, maximum 200 words) Training Module, Page 4, (01/2010)

PROPOSED TRAINING PROGRAM Section A: Project Title and Summary of the Research Project This section consists of text to be attached and should be completed in collaboration with the proposed supervisor(s). Both the candidate and the proposed supervisor(s) must sign on page 6 of the printed Training Module to confirm the accuracy of the proposed training program. Master's Award candidates must complete this section EVEN if a research supervisor is not secured. Attached documents may be prepared in the word processing software package of your choice, printed and inserted in the application form. Follow these guidelines to prepare your attached documents: At the top of each page, indicate your name and the title of the section. At the bottom of each page clearly indicate the page number. (e.g., 5a, 5b, 5c) The following details and / or instructions must be printed on the first page of the summary (they can be copied and pasted from this page and printed in smaller print, however they must be legible). Insert a margin of 2 cm (3/4 inch) - minimum - around the page. Use a font size of 12 point, black ink. Six lines per inch. No condensed type or spacing. Text to be attached 1. Project Title 2. Summary of the research project. In the "Proposed training program" section (page 5) of the Training Module, please include a clear Rationale and Objectives, Research Question or Hypothesis, brief description of proposed Methods for Data Collection and Analysis, and identification of Expected Results and Contribution to Knowledge on the topic of study. Please include appropriate references, where required, at the bottom of the space available. Maximum length of this description is 3 pages (including references). Training Module, Page 5, (01/2010)

Section B: Space, Facilities and Personnel Support Describe the space, facilities and personnel support which will be available to the candidate. No additional pages may be added. This section is not required for Master's Award candidates. Section C: Percentage of Time to be Spent on Different Activities In the table below, indicate the percentage of time to be spent on different activities. Awardees are expected to spend at least 75% of their time in research training. Activity Research Course work Teaching Clinical work Supervision Other (please specify) Percentage of Time * The total Percentage of Time for all activities can not exceed 100% THE SUMMARY OF THE RESEARCH PROJECT WAS WRITTEN BY: Candidate Proposed Supervisor(s) Both THE UNDERSIGNED AGREE THAT THIS ACCURATELY DESCRIBES THE TRAINING PROGRAM PROPOSED. Primary Supervisor Co-Supervisor Candidate Training Module, Page 6, (01/2010)