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CanHepC - Canadian Network on Hepatitis C
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CanHepC – TRR179 Internship Exchange Program Form
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CanHepC – TRR179 Internship Exchange Program Form
All applications should be sponsored by a CanHepC mentor or TRR179 PI
Personal information
First Name
*
Last Name
*
Email
*
Tel. (Home)
*
Tel. (Office)
Fax
Home Address
*
Other information
Degree Pursued
*
Anticipated Graduation Year
*
Research Interests
*
Proposed mentor
*
Project Title
*
Objectives
*
In the space provided below, please indicate your academic (short-term) and career (long-term) objectives. In addition, describe how the requested internship will help you achieve your objectives. Max 500 words
Qualifications
*
In the space provided below, please summarize any qualifications and experiences relevant to the requested internship. Max 500 words
Additional Information
In the space provided below, please include any additional information you would like considered for your application. Max 500 words
Documents to upload
Project description
*
Please provide a 2 page description of the project/new techniques &/or methods you wish to accomplish/gain during your internship including any preliminary work, aims & added value to both networks.
Files must be less than
5 MB
.
Allowed file types:
pdf
.
Your CV
*
Files must be less than
5 MB
.
Allowed file types:
pdf
.
Your motivation letter
*
Files must be less than
5 MB
.
Allowed file types:
pdf
.
Support letter from the host PI including a description of the facilities and resources that will be available to the intern
*
Files must be less than
5 MB
.
Allowed file types:
pdf
.
Confirmations
Please confirm that each item is completed before submitting your application to the CanHepC.
*
The applicant has confirmed and verified the contents of his/her application. If any of the information is found to be false, the application will be immediately rejected.
The applicant recognizes that if the CanHepC\TRR179 does not receive the supplemental documents by the application deadline, the application will neither be reviewed nor considered for acceptance.
The applicant, if awarded this scholarship, agrees to complete and submit a brief report at the end of the awarded term.
