RICHARD AND MARY PELLING BURSARY FUND The Richard and Mary Pelling Bursary has been made available through the generosity of Mr. Peter Gordon Pelling in memory of his parents, Richard and Mary Pelling. The Pelling Bursary will be awarded on the recommendation of the Pelling Educational Review Committee and is based upon demonstrated financial need. CRITERIA: 1. The award is for students in a health discipline at McMaster University, Faculty of Health Sciences or Faculty of Social Sciences. 2. The award will be open to full-time students enrolled in a health discipline and studying psychiatry, Faculty of Health Sciences / Faculty of Social Sciences, McMaster University. Applicants must have psychiatric clinical / research experience in the Integrated Mental Health Program (Hamilton Health Sciences, St. Joseph’s Healthcare) during the academic year (September 2010 – August 2011). 3. Applicants must demonstrate, in writing, how the bursary will financially benefit them in pursuing their studies in the field of psychiatry (mental health) at McMaster University. 4. The successful candidate(s) must agree to use the award in the academic year for which it has been presented. Students or residents will be eligible to apply for bursary monies each year of their program. 5. Should the recipient(s) be unsuccessful in or withdraw from the program, reimbursement of bursary monies will be negotiated at the time of notification. Funds will be sent when proof of full-time registration has been received from the appropriate department or School, Faculty of Health Sciences / Faculty of Social Sciences, by the Hamilton Health Sciences Foundation. 6. Preference will be given to applicants who have not previously been awarded a bursary from this fund, provided applicants are of equal merit. 7. The recipient of a bursary will be required to submit notification of successful completion of the funded year to the Foundation Office, 40 Wellington Street North, P.O. Box 739, LCD 1, Hamilton, Ontario, L8N 3M8 no later than October 1, 2011. 8. In addition to, but not to the exclusion of, financial need, the committee may consider the following in awarding funds where there are more qualified candidates than awards available: a) the appropriateness of the program to the goals and objectives of the individual applicant; a) recent participation in hospital, professional association, publications, university, volunteer and community activities; b) employment experience; c) overall ability to express oneself in the cover letter. APPLICATION PROCESS: 1. Ten copies of a complete application package must be received in the Foundation Office, 40 Wellington Street North, P.O. Box 739 LCD 1, Hamilton, Ontario, L8N 3M8, clearly marked “Application for The Richard and Mary Pelling Bursary”, no later than November 1, 2010. There will be no extensions. Recipients will be notified by January 31, 2011. 2. A complete application package includes: a) a completed application form; b) a cover letter indicating how the program will benefit the individual financially and reflective of the applicant’s professional, academic and clinical practice goals; c) a budget outlining how the bursary money would be spent; d) a current resume to include work history, educational history and membership and participation in hospital, professional, university, volunteer and community organizations and activities; e) transcripts of previous university courses or programs (photocopies are acceptable); f) proof of full-time registration (or application for registration) from the program administrator or director of the student’s or resident’s department or School, Faculty of Health Sciences / Faculty of Social Sciences, McMaster University (photocopy is acceptable); and, g) letters of support from two academic professors or advisors, and confirmation of the expected level of clinical experience for the student at Hamilton Health Sciences during the academic year from the following: i) ii) for medical/nursing students, a letter of reference from the Assistant Dean Undergraduate Medical Program; or for others, a letter of reference from the Chief of Academic Department of the applicant’s academic program, Hamilton Health Sciences. RICHARD AND MARY PELLING SCHOLARSHIP FUND The Richard and Mary Pelling Scholarship has been made available through the generosity of Mr. Peter Gordon Pelling in memory of his parents, Richard and Mary Pelling. The Pelling Scholarship will be awarded on the recommendation of the Pelling Educational Review Committee and is based on academic achievement. CRITERIA: 1. The award is for students in a health discipline at McMaster University, Faculty of Health Sciences or Faculty of Social Sciences. 2. The award will be open to full-time students or residents enrolled in a health discipline and studying psychiatry, Faculty of Health Sciences / Faculty of Social Sciences, McMaster University. Applicants must have psychiatric clinical / research experience in the Integrated Mental Health Program (Hamilton Health Sciences, St. Joseph’s Healthcare) during the academic year (September 2010 – August 2011). 3. The scholarship will be awarded to one or more students or residents annually, who demonstrate outstanding academic achievement and who wish to continue their studies in the field of psychiatry (mental health) at McMaster University and the Department of Psychiatry, Hamilton Health Sciences. 4. Applicants must demonstrate, in writing, how the scholarship will benefit them academically and clinically in pursuing their studies in the field of psychiatry (mental health) at McMaster University. 5. Applicants must submit a budget outlining how the scholarship money would be spent. 6. The successful candidate(s) must agree to use the award in the academic year for which it has been presented. Students or residents will be eligible to apply for scholarship monies each year of their program. 7. Preference will be given to applicants who have not previously been awarded a scholarship from this fund, provided applicants are of equal merit. 8. Should the recipient(s) be unsuccessful in or withdraw from the program, reimbursement of scholarship monies will be negotiated at the time of notification. Funds will be sent when proof of full-time registration has been received from the appropriate department or School, Faculty of Health Sciences / Faculty of Social Sciences, by the Hamilton Health Sciences Foundation. 9. The recipient of a scholarship will be required to submit notification of successful completion of the funded year to Hamilton Health Sciences Foundation, 40 Wellington Street North, P.O. Box 739, LCD1, Hamilton, Ontario, L8N 3M8 no later than October 1, 2011. 10. In addition to, but not to the exclusion of academic excellence, the committee will consider the following in awarding funds where there are more qualified candidates than awards available: (a) the appropriateness of the program to the goals and objectives of the individual applicant; (b) recent participation in hospital, professional association, publications, university, volunteer and community activities (c) employment experience; (d) overall ability to express oneself in the cover letter. APPLICATION PROCESS: 1. Ten copies of a complete application package must be received in the Foundation Office, 40 Wellington Street North, P.O. Box 739, LCD1, Hamilton, Ontario, L8N 3M8, clearly marked “Application for The Richard and Mary Pelling Scholarship Fund”, no later than November 1, 2010. There will be no extensions. Recipients will be notified by January 31, 2011. 2. A complete application package includes: (a) a completed application form; (b) a cover letter indicating how the program will benefit the individual in the pursuit of their education and reflective of their professional, academic and clinical practice goals; (c) a budget outlining how the scholarship money would be spent; (d) a current resume to include work history, educational history and membership and participation in hospital, professional and community organizations and activities; (e) transcripts of previous university courses or programs (photocopies are acceptable); (f) proof of full-time registration (or application for registration) from the program administrator or director from the student’s or resident’s department or School, Faculty of Health Sciences / Faculty of Social Sciences, McMaster University (photocopy is acceptable) (g) Letters of support from two academic professors or advisors, and confirmation of the expected level of clinical experience for the student or resident at Hamilton Health Sciences during the academic year from the following: iii) ii) iv) for medical/nursing students, a letter of reference from the Assistant Dean Undergraduate Medical Program; for residents, a letter of reference from Chief of the Department of Psychiatry; or for others, a letter of reference from the Chief of Academic Department of the applicant’s academic program, Hamilton Health Sciences. APPLICATION FOR THE RICHARD AND MARY PELLING BURSARY & SCHOLARSHIP FUND Please forward, no later than November 1, 2010 to: Hamilton Health Sciences Foundation, 40 Wellington Street North, P.O. Box 739, LCD 1, Hamilton, Ontario L8N 3M8 Ten (10) copies of the following: a) completed application form; b) a cover letter expressing how the scholarship will benefit you in the pursuit of your studies in psychiatric (mental health) medicine; c) budget outlining how the scholarship money would be spent; d) a current resume; e) transcripts from previous university courses and programs; f) letters of support from two academic professors or advisors; g) proof of full-time registration (or application for registration) from the program administrator or director of your department or school, Faculty of Health Sciences / Faculty of Social Sciences, McMaster University; and, h) a letter of reference from the Assistant Dean Undergraduate Medical Program for medical/nursing students, a letter of reference from Chief of the Department of Psychiatry or Chief of Academic Department of the applicant’s academic program for residents. Note: Your letter is a critical element in determining the success of your application. Your ability to demonstrate reflective thought and sequencing of ideas and present this in writing is a consideration in the rating of applications. Staff Member of HHSC: Yes No APPLICATION DATE: HOME PHONE # NAME: CELL PHONE # FULL ADDRESS: E-mail: Award: BURSARY (Awarded based on demonstrated financial need) SCHOLARSHIP (Awarded based on academic excellence) STUDENT OF WHICH SCHOOL OR DISCIPLINE? 1st YEAR: 2nd 3rd 4th Resident (scholarship only) Other: THE RICHARD AND MARY PELLING BURSARY & SCHOLARSHIP FUND By receiving this award, I agree that should I fail to successfully complete the academic year to which the bursary/ scholarship applies, or withdraw from the program during said academic year, I will repay the amount of funds disbursed by the Hamilton Health Sciences Foundation. SIGNATURE OF RECIPIENT DATE THE SUCCESSFUL CANDIDATE(S) WILL BE REQUIRED TO FURNISH THE FOUNDATION WITH A VALID SOCIAL INSURANCE NUMBER BEFORE TRANSFER OF