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2017 Asthma Canada / AllerGen Graduate Research Awards 1
Deadline for Submission: September 30, 2017 (11:59 pm)
Applicant Information
Name Institution
Project Title
Address
City Province Postal Code Email
Degree Program/Discipline Start Date dd/mm/year
End Date dd/mm/year
Phone (Cell) GPA
Supervisor Information
Name Email Telephone
Institution Program (Faculty/Department)
Address City Province Postal Code
Who wrote the project description included in this application? Please indicate which best applies:
Student Supervisor Combination Other (please specify)
Research Award funding in-hand or pending
Name of Organization Award Value Date (mm/year)
Application Form – Graduate Student Research Awards
2017 Asthma Canada / AllerGen Graduate Research Awards 2
Describe your role in the research project. (Maximum 200 words)
Describe how this project complements your long-term career goals. (Maximum 200 words)
2017 Asthma Canada / AllerGen Graduate Research Awards 3
Describe the training environment to be provided by the supervisor and host institution. (Maximum 200 words)
Application Submission
Completed applications must be sent electronically in a single PDF to Jenna Reynolds at
[email protected] no later than September 30, 2017 (11:59 pm). Late applications will not be
accepted.
Successful applicants will be notified no later than November 30, 2017.
For more information contact:
Jenna Reynolds
Director, Programs and Services, Asthma Canada
416-787-4050 x101
Signatures: I hereby understand and agree that any award made as a result of this application will be
subject to the Asthma Canada / AllerGen NCE Inc. terms and conditions governing these awards.
Applicant Name Signature Date
Supervisor Name Signature Date
