Canadian Queen Elizabeth II
Diamond Jubilee Scholarships
Scholar Narrative Report
For incoming Queen Elizabeth Scholars.
Directions
Please complete the following as accurately as possible. The information you provide will be compiled for reporting
purposes. It will also help Universities Canada in building a stronger program. Once the form is complete, please send it
directly to the representative at your Canadian university who will then submit it to Universities Canada.
Section 1: Background information
Scholar’s name:
First name
Date of birth:
Last name
DD/MM/YYYY
Academic information:
Gender:
Program:
Year:
Level:
Section 2: Scholarship information
Canadian University
Travel dates:
Scholarship dates:
DD/MM/YYYY
DD/MM/YYYY
Arrival in Canada
Departure from Canada
DD/MM/YYYY
Start date of studies
DD/MM/YYYY
End date of studies
Themes of internship or areas of research/study (check all that apply)
Aboriginal Issues
Aboriginal education
Aboriginal rights
Aboriginal heritage preservation
Children and Youth
Child education
Child safety and security
Economic Growth
Mining
Business development
Building economic
foundations
Growing business
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Sustainable economic growth
Education
Primary and secondary
Post-secondary
Access
Climate change
Mining
Environmental sustainability
Urbanization
Land degradation
Clean water and sanitation
Research and innovation
Conservation
Renewable energy
Assistance and nutrition
Access
Sustainable agriculture
Gender equality
Supporting women's rights
Human rights
Democracy
Global health
Nursing
Mental health
HIV/AIDS
Nutrition
Maternal/child
Environment
Food security
Gender
Governance
Health
Health administration
OTHER (please specify):
Please indicate any changes to the themes from your pre-departure form:
Section 3: Scholar reflections
1)
Specific goals listed in your pre-departure form:
a)
Upon reflection of your scholarship, please select one of the following:
Please explain:
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2)
Please read each statement below and indicate your level of agreement.
a)
I received mentoring/professional support from my Canadian university during my scholarship.
Please describe support given:
b)
My QES experience has strengthened my technical/professional skills.
Please describe what skills have been strengthened:
c)
My QES experience has improved my communication skills.
Please explain:
d)
My QES experience has improved my networking skills.
Please explain:
e)
My QES experience has enhanced my personal/professional networks.
Please explain:
f)
My QES experience has increased my leadership skills.
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Please explain:
g)
My QES experience has increased my ability to work in a cross-cultural environment.
Comments:
h)
My QES experience has increased my employability.
Comments:
i)
I feel that the QES experience has allowed me to make an increased contribution to local/global communities.
Please explain:
j)
My time spent in Canada met my expectations.
Please explain:
k)
Overall, I am satisfied with my QES experience.
Please explain:
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3)
Approximate # of community engagement activities conducted in Canada:
4)
Did any of your activities involve a local Community Foundation?
5)
Please rate your level of satisfaction with the Canadian community engagement activities.
Please describe your Canadian community engagement activities:
6)
Frequency of cross-cultural networking activities:
Comments:
7)
Please rate your level of satisfaction with the networking activities.
Comments:
8)
I engaged with other Queen Elizabeth Scholars during my scholarship:
Comments:
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9)
Reflecting on all of the above, what are your most important lessons learned? (up to 100 words)
10) Share a success story. What makes it a success story? (up to 200 words)
Disclaimer and signature
I hereby certify that the above statements are true and complete to the best of my knowledge.
Scholar’s name:
Date:
DD/MM/YYYY
Section 4: Comments from the Canadian university
Comments:
I hereby certify that I have read the contents of this QES report
University representative’s name:
Date: DD/MM/YYYY
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