Fellowship
Applications 2021

Personal Information

*First name:

*Last name:

*Gender: Select your answer Male Female Other I choose not to respond

*Email address:

*Phone number:

*Citizenship:

*Country of residence:

Additional information

Do you consider yourself to be Indigenous or a member of an Indigenous Community?: Select your answer I choose not to respond Yes No

Do you consider yourself to be a member of a visible minority?: Select your answer I choose not to respond Yes No

Do you consider yourself to be a person with a disability?: Select your answer I choose not to respond Yes No

Do you consider yourself to be a member of the lesbian, gay, bisexual, transgender plus (LGBT+) community?: Select your answer I choose not to respond Yes No

Educational background

*Are you currently enrolled or will you be enrolled in a graduate program (Masters or PhD) between January - April 2021?: Select your answer Yes No

Last name and First Name of your Graduate Degree Advisor:

Advisor Email address:

Last name and First Name of your Graduate Degree Co-Advisor, (if applicable):

Co-Advisor Email address, (if applicable):

*Are you currently enrolled in a Canadian university or will you be enrolled in a Canadian university between January-April 2021?: Select your answer Yes No

*Name of Enrolled University:

*Name of Enrolled Department:

*Are you a member of specific Research Institute or Program? Select your answer Yes No

*Estimated Graduation Year:

Fellowship application

*Have you received a Borealis AI Fellowship before? Select your answer Yes No

*Area of Research:

*Research Proposal Title:

*Research Proposals (1,000 words maximum): Upload

*Resume (with links to publications, GitHub, etc., if applicable): Upload

*Transcripts - 1st Year Bachelor Degree to Present (English & original language - combine into 1 file) Upload

References

*Reference #1 First Name:

*Reference #1 Last Name:

*Reference #1 Email :

*Reference #1 Telephone Number:

*Reference #1 Affiliation (University/Organization):

*Reference #1 Affiliation (Title):

*Reference #2 First Name:

*Reference #2 Last Name:

*Reference #2 Email :

*Reference #2 Telephone Number:

*Reference #2 Affiliation:

*Reference #2 Affiliation (Title):

Other

Additional Comments (optional):