LAST NAME, First Name

University of Alberta, Faculty of Nursing Postdoctoral Fellowship
Application Form /
Please read the Program Guidelines carefully before completing this application.
Complete Application Packages are due by 5 pm MT on Tuesday, January 31st, 2016

Section 1: Information about the Applicant and Supervisor

Section 1.1: PostdoctoralApplicant Information

Last Name / First Name
Citizenship / Canadian
Permanent Resident / Country of Origin
Mailing Address
Phone / E-mail address
RN with College and Association of
Registered Nurses of Alberta / Yes
No / Registration
Number
Current academic program and/or profession
Current academic institution(s) and/or employer(s)
Highest degree or professional designation to be completed by June 30, 2017

Section 1.2: Postdoctoral Supervisor Information

Last Name / First Name
Employer / Position

Section 2: Personal Research Project

Section 2.1: Project Overview

Title of Research Project:
Keywords: Please provide up to a maximum of five (5) specific keywords or descriptive technical terms or methodologies that best describe the proposal (e.g. Medline Headings).

Section 2.2: Research Project Summaries

2.2.1: LayProject Summary (maximum 250 words)

Provide a summary in lay terms of your research project. We are looking for a brief description of the research, why you are conducting the research

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2.2.2: ScientificProject Summary (maximum 250 words)

Provide a scientific summary of your proposal, highlighting project objectives, method, data collection, analysis, milestones and deliverables

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Section 2.3: Research Project Proposal (maximum 750 words)

Provide an overview of your proposed research project. State the proposed research question(s). Where applicable, clearly state the underlying hypothesis. Describe the methodological research approach including study design, data collection, analysis plan, etc. Describe why you feel the work you plan to carry out is important.

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Section 3: Applicant Benefit and Mentorship

3.1: Career Aspirations (maximum 500 words)

Describe your career plan and how a Faculty of Nursing Fellowship will help you achieve your career goals.

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3.2: Mentorship Plan (maximum 500 words)

Describe the mentorship plan for your proposed fellowship.

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Section 4: Curriculum Vitae and Experience

4.1: Transcripts

Official transcripts must be provided for all post-secondary studies to-date. These original transcripts should be provided in a sealed envelope directly from the issuing institution.

Please list the institutions from which we will receive your transcripts.

Name of Institution / Academic Degree granted (or worked towards, e.g. undergrad courses) / Discipline

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4.2: Applicant’sCurriculum Vitae

Pleaseprovide one copy of your academic CV. Ensure that it includes:

  • list of current/past professional employment and volunteer experience
  • list of specialized training, conference attendance, collaborations, etc.
  • list ofselected publications and presentations

4.3: Postdoctoral Supervisor’s Curriculum Vitae

Pleaseprovide one copy of your proposed postdoctoral supervisor’s academic CV. Ensure that it includes:

  • list of current/past professional employment and volunteer experience
  • list of specialized training, conference attendance, collaborations, etc.
  • list ofselected publications and presentations

Section 5: Postdoctoral Supervisor Endorsement Letter

5.1: Endorsement Letter

Please provide a letter of endorsement for your research project from your proposed Faculty of Nursing postdoctoralsupervisor. This letter should be provided in sealed envelope directly from the supervisor.

Section 6: Signatures

Applicant Name / Applicant Signature / Date
Postdoctoral Supervisor Name / Postdoctoral Supervisor Signature / Date

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