School of Graduate Studies
GRADUATE AWARDS OFFICE
2010-2011 GENERAL AWARD APPLICATION FORM
AZRIELI FOUNDATION GRADUATE FELLOWSHIP
IN HOLOCAUST STUDIES
GENERAL INFORMATION (All information must be typed or printed clearly)
FAMILY NAME Please print family name in capital letters | | | | | | | | | | | | | | | | | |
SOCIAL INSURANCE NUMBER | | | | | | | | |
GIVEN NAME | | | | | | | | | | | | | | |
FORMER BIRTH NAME | | | | | | | | | |
MALE ?
FEMALE ?
| | | | | | | | | | | | | | | | | | | |
ID NUMBER | | | | | | |
ADDRESS (for correspondence)
STREET NUMBER/NAME APT. NO | | | | | | | | | | | | | | | | | | |
MUNICIPALITY | | | | | | | | | |
PROVINCE/STATE/COUNTRY | | | | | | | |
POSTAL CODE | | | | | |
PHONE NUMBER (HOME) | | | | | | | | | |
PHONE NUMBER (OFFICE) | | | - | | | | |
ACADEMIC HISTORY (Please provide the following documents)
1) unofficial transcripts of all university studies (bachelor, master, doctoral);
2) a list of all publications and relevant professional and research experience;
3) research proposal clearly indicating your area of research in destruction of European Jewry in the 20th century (maximum 500 words);
4) an up to date curriculum vitae;
5) one letter of recommendation from your supervisor or a faculty member who has taught you.
Program of study for which scholarship is being sought: ? Master’s ? Doctoral
Discipline: Date of entry in the program:
Which award are you applying to?
SUBMIT COMPLETED APPLICATION
Completed applications must be received by the application deadline with all required documents attached. Applications are to be submitted to: YOUR DEPARTMENT.
DEADLINE DATE: September 30th, 2010 noon to the
MONTREAL INSTITUTE FOR GENOCIDE AND HUMAN RIGHTS STUDIES MIGS Room LB-1029.5
THIS DECLARATION IS TO BE SIGNED BY ALL APPLICANTS
I do hereby declare that the information provided on this application and on the documents which accompany it are true, accurate, and complete.
Signature: Date:
FOR OFFICE USE ONLY Application received:
Verified by:
Notes:
School of Graduate Studies 2/2 6/08