Application for the UPEI Science Undergraduate Research Award (SURA).
Part I (Student)
Family name of student
Given names
UPEI student #:
Initials
ACADEMIC BACKGROUND (including ongoing post-secondary degree)
Degree
Name of Discipline
Institution
Bachelor’s
Department
Year/Month of
expected degree
completion
UPEI
SCHOLARSHIPS AND OTHER AWARDS RECEIVED (start with most recent)
Name of the award
Location of tenure
Period held
(yyy/mm-yyy/mm)
OTHER INFORMATION
Citizenship
Canadian
Permanent resident
English
French
International student
Language of correspondence
Current address
Permanent mailing address (if different from current address)
Telephone number
E-mail address
Please type the information required (not hand write) and ensure that you submit this form with a letter of interest
addressing the criteria indicated in the announcement of SURA. Also ensure that transcripts are received in the
Research Office before the deadline: Tuesday, February 16 2016, 4:00 PM.