General Instructions for all applicants
Applications should be typewritten. Certain tables or sections of the application form can be expanded to include additional entries as required; however, please respect the specified page limits for the description of past research and the research proposal.
While CIHR will receive and review applications in either English or French, Japan Society for the Promotion of Science (JSPS), requires nominations to be submitted in English.
Therefore, French applications (including letters of reference and other supporting documents) that are selected by CIHR for nomination will be translated by CIHR. Upon request, applicants will be given an opportunity to review the translation before the English version is sent to JSPS.
Specific Instructions:
Scholarships, Fellowships, and Other Awards Received
–
Starting with your most recent awards (including CIHR awards), list the names of the awards you have received, the value, the type (institutional, provincial, national, or international), the location of tenure, and the period held. Only list the support that was awarded on the basis of academic, research, leadership and/or communication abilities.
Proposed host researcher – You may list multiple potential host researchers/institutions in priority order and identify the specific research divisions that are of particular interest to you.
You must also include evidence of exchanges or letters of acceptance/invitation from potential host researchers (e.g., copies of e-mail communications with potential hosts).
Research plan (proposed study program) – Describe your current and proposed research projects and interests, including those that may diverge from your current research if you wish to strengthen your expertise in them through the summer programs. Explain the benefits that the program will provide to your professional development, and the broader impacts of the proposed research to the field.
Two Letters of Reference – Letters of reference are required from two faculty members or other senior individuals qualified to comment on your abilities and potential as a scientific researcher. Reference letters should address the program’s selection criteria. One reference must be from your current research advisor. (If you do not have a research advisor yet, ask your academic advisor or Department Chair). Do not secure references from proposed foreign hosts or host institutions.

Supplementary Documents – The following documents must be submitted:

Official transcripts of the candidate's complete academic record to date (CIHR will only accept an official student's copy of the transcript if submitted in the original sealed envelope from
 the institution. Certified true copies will NOT be accepted).
Proof of citizenship or permanent resident status (if born outside Canada): e.g., photocopy of passport or Permanent Resident Card.
The application must be submitted directly to CIHR by November 1, 2004.

Application Form
Summer Programs in Japan
1. Name in full: ____________________________________________________________________ family first middle
Title: Dr.
□
Mr.
□
Ms.
□
Nationality/Citizenship: ____________________
Date of Birth : _____/_______/_______
day month year
I wish to receive my correspondence from CIHR in English____ French____
2. Current address and telephone or facsimile number (work and/or home) and e-mail address:
Address __________________________________________________________________________
__________________________________________________________________________
Phone ______________________________________ Fax ________________________________
E-mail _________________________________________________________________________
Permanent mailing address (if different than current address):
Address __________________________________________________________________________
_________________________________________________________________________
3. Person to be notified in your home country in case of emergency:
1) Name in full: _________________________________________________________________
2) Address and telephone and/or facsimile number and e-mail address: ______________________
_______________________________________________________________________________
3) Relationship to you: ____________________________________________________________

4. Current position or status and name of your present university or employer:
Position __________________________________________________________________________
_________________________________________________________________________
Phone ___________________________________ Fax __________________________________
Name of research advisor and affiliation in your home research institute or university:
______________________________________________________________
5. Educational background (graduate and undergraduate level – begin with current degree):
Degree Name of discipline Department, institution and country
Month and year started
Month and year awarded/expected
6. Academic awards:
(Level: institutional, provincial, national or international)
(Type: academic, research, leadership, communication)
Name of Award Value Level Type
7. List of publications (including graduation theses):
(Indicate the following: authors (all); year; title; journal; vol. no., pp.)
Location Period held

8. Employment record (Begin with your most recent employment.):
Organization (name and location) Period of employment Position - Type of work
9. Subject and achievements of past research (Maximum length: half of one page)

10. Research plan in Japan (Maximum length: 1.5 pages):
Please include the following items: 1) current research, 2) proposed research 3) expected outcome of the proposed research.

11. Name of proposed host researcher and his/her affiliation in Japan
Please list in priority order and check "yes" or "no" as to whether you have contacted and obtained the proposed research advisor's consent in advance.
1) Yes / No
2 ) Yes / No
12. Language proficiency (evaluate your ability using Excellent, Good, Fair, or None):
Writing Reading Speaking/Hearing
English _______________ _______________ _______________
French _______________
Japanese _______________
Other _______________
13. Past stay(s) in Japan:
Place
_______________
_______________
_______________
Duration
_______________
_______________
_______________
Purpose

I certify the above information to be accurate and correct.
Applicant's signature: _____________________________________
Date of application:_______________________________________
Please attach the following documents :

Two letters of reference (including one from current advisor)

Up-to-date transcripts

Communication with potential host researchers

Proof of citizenship or permanent resident status, if born outside Canada