Mitacs Globalink Research Award – Sorbonne Universités
For senior undergraduate and graduate student research at Sorbonne
Universités
Proposal
Instructions
1. Access detailed research award information at:
https://www.mitacs.ca/en/programs/globalink/globalink-research-award-sorbonne
2. Take note of the deadline for applications below
3. Read through and complete the following application
4. Save your completed application as a PDF file and email to apply@mitacs.ca with the
subject heading “[Student’s first and last name] _ GRA-Sorbonne”
5. Note: only the signature page of the proposal should be saved as a scanned PDF file.
6. Contact Mitacs International at international@mitacs.ca if you have any questions
regarding the application or eligibility requirements
The call for applications will open on January 15, 2015 and will close March 13,
2015 at 5 p.m. PDT.
A complete application package includes the following:
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Proposal application (please use template provided)
Signature page signed by all parties, including the home university’s Office of Research
Services (or equivalent thereof)
Student CV (use the template on the Mitacs website)
Student transcripts (undergraduate students only)
Letters of support from the home and host supervisors, respectively. Each letter must:
o Be written on the university letterhead and signed by the supervisor
o Include the respective supervisors’ contact details, including title, department
affiliation, and university or institution, in English or French
o Include details outlining support for the student and the research project
Host Supervisor’s CV, outlining the:
o Academic affiliations and history
o Funding history
o Publications and/or intellectual property
o Graduate students supervised
Mitacs Globalink Research Award – Sorbonne Universités
January 2015
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Applicants are asked to submit the following documents at least three weeks prior to their
intended departure to commence their research project:
 Mitacs Student Code of Conduct and Ethics Form**
 International Pre-Departure Form**
 Any supplementary documents (as applicable)
**Please note that the International Pre-Departure form and Mitacs Student Code of
Conduct and Ethics form may be forwarded to Mitacs after submission of your
application; however, funds cannot be released until Mitacs receives these forms.
Travel to the destination prior to the approval of the award is not permitted. Mitacs and
Sorbonne Universités are not responsible for any costs incurred before the application is
approved.
Mitacs Globalink Research Award – Sorbonne Universités
January 2015
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Project Details
I.
Title of Project:
II.
Research Keywords (Up to 10 keywords):
III.
Academic Discipline:
Business
Computer
Science
Earth Sciences
Engineering
IV.
Life Sciences
Social Sciences, Arts &
Humanities
Physical Sciences
Mathematical Sciences
Proposed Period of Project and Travel:
Project start and end dates are the period of time the student will be working on the
research project abroad (12–24 weeks/three–six months).
Project Start Date (dd/mm/yyyy):
Project End Date (dd/mm/yyyy):
V.
City, Region, Country, Location of Project:
VI.
Name of host institution:
VII.
Does this project create a new international collaboration?
Yes
No
If yes, does it create potential for future collaborations?
Yes
No
If no, please describe briefly the pre-existing international collaboration (include a
summary of the collaboration and length of time, any past exchange of personnel, etc.)
Mitacs Globalink Research Award – Sorbonne Universités
January 2015
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Participant Information (Duplicate relevant section(s) as needed for multiple supervisors.)
Home Academic Supervisor at a University in Canada:
Name:
University:
Department:
Address (at university)
City, Province:
Postal Code
Phone:
Email:
Please indicate which research group you are associated with:
Please indicate if you are associated with the following:
CECR __Yes __No
BL-NCE __Yes __No
Quebec Only: Please provide your PIN FRQ
ABCDE1234 Format:
Host Academic Supervisor at Sorbonne Universités:
Name:
Sorbonne Institution:
Department:
Address (at university):
City, Country:
Postal/Zip Code
Phone:
Email:
Student:
Name:
Degree Program (undergraduate,
Master’s or PhD):
Expected graduation date:
University:
Department:
Mitacs Globalink Research Award – Sorbonne Universités
January 2015
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Address (at university):
City, Province:
Postal Code
Phone:
University Email:
Alternate Email:
Is the student currently participating in a joint degree/ cotutelle? __Yes __No
If yes, with which universities:
Has the student held any previous Mitacs funding?
__Yes __No If yes, which Mitacs award and when:
Citizenship: Please indicate your status in Canada:
Canadian citizen:
__Yes __No
Permanent Resident:
__Yes __No
Study Permit:
__Yes __No
If on a study permit, please indicate citizenship:
Please indicate if you are:
Gender: Male
Yes
No
Gender: Female
Yes
No
How did you first hear about Mitacs?
Please check all that apply:
Participated in a Mitacs program previously*
Directly from the Mitacs website
Via social media postings (Twitter, LinkedIn, Facebook, etc.)
Received a hard copy version of a mail out or post card
Received an email of the call from the Mitacs Proposals Office
Contacted by Mitacs directly via a Mitacs representative**
From the institution’s Graduate Studies and/or Vice President of Research offices
From the institution’s International Student Services office
From a student at the institution
From a colleague at the institution
From a colleague at a different institution
*If you previously participated in a Mitacs program, please specify which one:
**If you were contacted by a Mitacs representative, please indicate who:
Mitacs Globalink Research Award – Sorbonne Universités
January 2015
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Proposal
Section 1.
Student Statement of Interest:
Describe why you are interested in participating in Mitacs Globalink and how this experience will
benefit your research career. 300 words maximum.
Section 2.
Research Project Proposal
Please provide a brief overview, hypothesis, objectives, methodologies, scholarly references,
and anticipated outcomes of the research project. Please also include detailed information on
the interaction between the host supervisor and the student and where these interactions will
take place. One page minimum, two pages maximum.
Proposed Budget
The maximum award from Sorbonne Universités is $5,000 CAD for accommodation and local
expenses and projects may last 12 to 24 weeks.
Duration of project (in weeks):
In the budget table below, include specific line items for each expense falling under travel costs
and living expenses headings (e.g. accommodation, meals, travel/medical insurance).
Note: The maximum award from Sorbonne Universités is $5,000. This funding will be directly
deposited into the applicant’s bank account within two weeks of their arrival in France to support
the Canadian student’s accommodation and local expenses while in France.
Amount
Required
Allocation of
Mitacs $
Allocation
of
Other $
Travel costs:
Air
Ground
Visa(s)
Insurance
Other
Living expenses:
Accommodations
Food/Meals
Personal
Other
Total required:
Total funds requested from
Mitacs:
Mitacs Globalink Research Award – Sorbonne Universités
January 2015
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If additional funds are required for this project, outside of those provided by Mitacs
and Sorbonne Universités, please indicate the source(s) of these funds:
Status of the additional funding:
Pending
Confirmed
Additional resources provided to the student during the project:
Please detail additional resources provided to the student during the project, such as office
space, supplies, stationary, access to research materials and equipment, etc.
Risk, Permits, and Authorizations
Section 3. Will the proposed research take place outside of the lab or normal
business environment?
Yes
No
If yes, please complete the following section to indicate what, if any, impact there may be on
the environment:
a. Main characteristics of the location (i.e. physical description & coordinates)
b. Principal activity(ies): for each activity, list the environmental elements affected
c. Are authorizations, permits, or licenses required to undertake any activity during
the project?
Yes
No
If yes, have the appropriate authorizations, permits, or licenses been obtained?
Yes
No
Please note: Mitacs may request to receive a copy of these.
Section 4. Does the proposed research involve living human subjects (includes
conducting interviews) or human remains, cadavers, tissues, biological fluids,
embryos, or fetuses?
Yes
No
If yes, has the proposal been reviewed by the participating Research Ethics board and an approval report
from the committee received?
Yes
No
Mitacs Globalink Research Award – Sorbonne Universités
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Please note: Mitacs may request to receive a copy of the report.
Section 5.
Yes
Does the proposed research involve animal subjects?
No
If yes, has the proposal been reviewed by the participating Animal Care Committee or equivalent thereof
and an approval report from the committee received?
Yes
No
Please note: Mitacs may request to receive a copy of the report.
Section 6.
Yes
Is a biohazards review required?
No
If yes, has the necessary review/report from your institution been obtained?
Yes
No
Please note: Mitacs may request to receive a copy of the report.
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January 2015
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Mitacs Globalink Research Award – Sorbonne Universités
For senior undergraduate and graduate student research at Sorbonne
Universités
The participants listed below have agreed to set in place an international research project based
upon the attached proposal. Upon research approval, Mitacs shall forward funds to the Office of
Research Services, or equivalent thereof, at the home university, to be administered as a
research grant according to the university’s policies and procedures in care of the identified
home academic supervisor. The full amount must be expended towards the student’s travel
costs as approved by Mitacs.
In acknowledging that international exposure can greatly enhance a student’s learning and
experience, Mitacs will approve international travel provided that participation does not impact
the safety and security of the student and meets the policies outlined by the home Canadian
university. By signing this memorandum, you are acknowledging that the home Canadian
university agrees to assist the student in meeting all university requirements pertaining to
research abroad and provide the student with a pre-departure orientation, and that the student
understands that he/she is responsible for obtaining insurance appropriate for the travel
destination. Mitacs is unable to assume liability for any losses including—but not limited to—
accidents, illness, flight cancellation, loss of baggage, illegal acts, and vandalism that may occur
during the project period. All parties also agree that the student is expected to provide Mitacs
with a final report, and all participants will complete an exit survey within one (1) month of
project completion.
The participants listed below also agree that Mitacs can disclose personal information included
in this proposal to funding partners for the purpose of evaluating the initiative and its outcomes.
Please note that the following information including the title of the project, description of
research project, name of student, names of supervisors and involved universities may
be posted on www.mitacs.ca/research and may be used by Mitacs to publicize the Mitacs
Globalink Research Award.
Title of Project: [Title]
Project Overview: Using simplified language understandable to a layperson, provide a
general, one-paragraph description of the proposed research project to be undertaken by the
student(s) as well as the expected outcomes. (Approx. 150 words)
Mitacs Globalink Research Award – Sorbonne Universités
January 2015
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Participant Signatures
Student:
Name:
Department:
University:
Signature:___________________________ Date:_________
Home Academic Supervisor at Canadian University:
Name:
Department:
University:
Signature:___________________________ Date:_________
Host Academic Supervisor at Sorbonne Universités:
Name:
Department:
University:
Signature:___________________________ Date:_________
Office of Research Services Representative at Canadian University:
Name:
Position:
University:
Signature:___________________________ Date:_________
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