Sterling Clarren FASD Research Award Application Form

CHECKLIST: A complete application package includes the following:

Completed application form
Applicant CV
Signed signature page, emailed to info@canfasd.ca
Letter of support from two references – letters must:
- Be submitted via email with applicant name in subject line from the individual’s personal email account (university account for Supervisor/Department Head) and contain their contact details, including title, department affiliation, and university, in English or French
- Speak to the applicant’s research activity and potential within the field of FASD, positive or promising aspects of the applicant’s character, and examples of achievements

Applicant Information

Name *

First

Last

Current position: *

Master's student
Doctoral student
Post-Doctoral Fellow
Early Researcher (within 3 years of Faculty appointment)

University: *

Department: *

Address (home or university): *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Phone *

University email: *

Email

Confirm Email

Alternate email: *

Email

Confirm Email

Applicant Statement of Interest *

Describe why you are interested in applying for the Dr. Sterling Clarren FASD Research Award and how this experience will benefit your research career. (300 words maximum)

Applicant CV *

Click or drag a file to this area to upload.

Please upload your Curriculum Vitae

Applicant Information

References

Reference 1:

Reference 2:

Project Details

Dr. Sterling Clarren FASD Research Award Memorandum