ACSN Student Networking Award

ACSN STUDENT NETWORKING AWARD

Application Form

Applications must be submitted to the ACSN secretariat via the form below.

Applicants are  reminded to ensure that the two letters of reference and recommendation are sent in confidence DIRECT to acsn.nl@gmail.com.

All fields are mandatory. If you have any questions, please contact us via acsn.nl@gmail.com.

Please note that scholarship applications are only meant for studies with a specific Canadian content; not for exchange programs or studies in Canada with no specific Canadian content, or studies not aimed at further research into a Canadian topic.

Section A: Personal information

Full name *

Email address *

Address home

Address *

Telephone *

Address Educational Institution

Address *

Telephone *

Communications about an award should be sent to *

Home

Educational Institution

Academic qualification and distinctions *

Discipline and/or department within institution *

Please provide a brief statement outlining your background field(s) of specialization and particular areas of interest in Canada Studies *

Section B: Plan of study while in Canada

Discipline in which study/research is to be undertaken *

Study topic *

Section C: References

Names and addresses of two academics who have been asked to submit letters of recommendation on your behalf direct to the ACSN. Applicants are  reminded to ensure that the two letters of reference and recommendation are sent in confidence DIRECT to acsn.nl@gmail.com.

Reference 1 *

Reference 2 *

Section D: Program of research in Canada and sources of financing

Please explain clearly (not more than 500 words) the present status of your studies and describe your study plans in Canada, including contacts such as scholars, research centers, academic institutions or libraries/Archives.

Anticipated date of departure *

Day

Month

Year

Anticipated date of return *

Day

Month

Year

Please provide a budget of revenues and expenses *

Please provide information on potential and actually known sources of other funding (if any) for this project

Section E: Acceptance of the conditions of award

I confirm that I, am a full-time student at *

If I am granted an award for the Canadian Studies research purposes described in this application, I agree:

to make all the necessary arrangements relating to the study visit;
to devote the entire period of time in Canada for which the award is received exclusively for the proposed research;
that if I have supplemental funding otherwise obtained , I will devote time to research under this award that is at least in proportion to that part of the total funding which is derived from this award;
to provide a short report of my research trip to Canada within 60 days of my return to the Netherlands
to credit ACSN for its support in case of publication
to provide the ACSN with two copies of the M.A. Thesis (or Ph.D. dissertation which results from research for which the award was received.

I understand that medical insurance coverage while in Canada is my personal responsibility.

I agree *

I agree

Name applicant *

Date *

Day

Month

Year