CUASF – Canadian Urological Association Scholarship Foundation
Français
Contact
Toggle navigation
Home
CUASF New Investigator Research Scholarship
Terms of Reference
Application Form
CUA Scholarship Fund – Bladder Cancer Canada
Terms of Reference
Application Form
CUA-Astellas Research Grant
Terms of Reference
Application Form
CUA-CUOG-Astellas Research Grant
Terms of Reference
Application Form
CUA-Pfizer Incontinence Fellowship Grant
Terms of Reference
Application Form
CUA-SIU International Scholarship Program
Terms of Reference
Application Form
KCRNC-KCC-CUASF Kidney Cancer Research Grant
Terms of Reference
Application Form
Contact
CUASF-CMSHC Grant TOR
Terms of Reference
Application Form
CUA-Pfizer Incontinence Fellowship Grant
Form type
*
Name (in full)
*
Date of birth
*
CUA Membership Number
*
Citizenship
*
Mailing Address
*
Email address
*
Telephone # work
*
Telephone # home
*
Fax
*
Location of Residency Training
Year of Residency
Name of Institution and Department where applicant will conduct his/her academic/research activities
*
Academic Rank to be held by the applicant during tenure of the research
Name, address and telephone number of the Department/Division Chair person
*
Name of Supervisor of Research Project
Type of Research (eg. Clinical, translational, interventional, basic research, genetic studies, epidemiology, health outcomes, and quality of life studies)
Research Experience (a brief description of work in which the applicant has participated)
*
Briefly describe the environment and the research facilities
*
Briefly describe your long term career plans and research objectives and how this fellowship will impact these objectives
*
Date
*
Place
*
Name of Applicant
*
Checklist
Could not find the language line "scholarshipform_chk_research_proposal"
Summary of the research proposal not exceeding one (1) single spaced, typewritten page
Curriculum Vitae of Fellow (Please submit a pdf version of your Common (CIHR) CV)
Letter outlining the clinical and/or research plan for fellowship not exceeding (5) single-spaced pages (please see suggested headings in Terms of Reference)
A maximum of three (3) published reprints or pre-prints (if applicable)
Project budget
Letter of support from the academic institution fellowship program director or alternate agreeing to conform to the Terms of Reference. The letter should indicate the level of support and commitment by the university/institution for the candidate.
Letter(s) of support from proposed mentors describing how they will execute their mentorship to facilitate successful completion of the proposed research
Could not find the language line "scholarshipform_chk_name_info_reviewer"
Two (2) additional letters of recommendation, one (1) of which should come from an individual not associated with the Institution where the proposed research will take place.
Evidence of appropriate Ethics Committee approval or application for approval must be included along with the consent forms where human subjects are involved in the study.
In addition to the items listed above, renewal applications must include a progress report.
×
Form submission
Application has been submitted successfully