GRAD - IBET PhD Fellowship Application

Student Information
Student name Student name First Last
Student Number (100xxxxxx)
University Email Address
Phone Number Phone Number - ### - ### ####
Citizenship Status
Self Identification

Self Identification Indigenous Black
Please specify:

Please specify: First Nations Inuit Metis
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Please specify: African-Canadian Caribbean-Canadian Afro-Caribbean Heritage
Fellowship Details
Proposed Start Term of Fellowship
Proposed Starting Year of Fellowship
Proposed Area of PhD Research
Proposed Program of Study
Proposed Supervisor (if already identified)
Statement of Intent
Please submit a one page (no more than 300 words) statement of academic intent highlighting the following:
- Your career vision
- Your involvement and contribution to the student community with which you identify.
Maximum of 300 words allowed. Currently Entered: 0 words.
Required documents

The following documents should be uploaded with this application.
Upload your CV

Attach Files
Letter of support from your supervisor (either potential or confirmed)

Attach Files
Notice, Consents, and Declarations of Applicant

Your personal information provided on this application form, in the required documentation, and in all other communications related to your application and award of an IBET Fellowship, will be used by the University of Ontario Institute of Technology to administer and finance the program.

Under the Freedom of Information and Protection of Privacy Act, the University of Ontario Institute of Technology has responsibilities respecting the proper collection, retention, use, and disclosure of personal information. The personal information on this form is collected in accordance with Section’s 382) and 411) of the Freedom of Information and Protection of Privacy Act (FIPPA), R.S.O. 1990, c. F.31 as amended. The information provided will not be used for any purposes other than those stated upon this form unless the applicant provides expressed consent. Should you have any questions concerning your personal information, please contact the School of Graduate and Postdoctoral Studies, 905.721.8668, ext. 6209. The University of Ontario Institute of Technology is fully compliant with FIPPA and endeavours at all times to treat your personal information in accordance with this law.
I hereby certify that all statements on this application are correct and complete. I have given complete and true information on this application form and in the required supporting documentation. I understand that if any information or statements on this form are proven to be false, the IBET Fellowship may be rescinded.

I hereby certify that all statements on this application are correct and complete. I have given complete and true information on this application form and in the required supporting documentation. I understand that if any information or statements on this form are proven to be false, the IBET Fellowship may be rescinded. I agree
I understand that to hold the IBET Momentum Fellowship, I must meet the following requirements:
- Admitted into a PhD program in the Engineering and Applied Science.
- Maintain satisfactory academic and research progress in the PhD program.
- Award is subject to the approval of Dean, Faculty of Engineering and Applied Science.

I understand that to hold the IBET Momentum Fellowship, I must meet the following requirements:
- Admitted into a PhD program in the Engineering and Applied Science.
- Maintain satisfactory academic and research progress in the PhD program.
- Award is subject to the approval of Dean, Faculty of Engineering and Applied Science. I agree

GRAD - IBET PhD Fellowship Application

GRAD - IBET PhD Fellowship Application

Student Information

Fellowship Details

Statement of Intent

Required documents

Notice, Consents, and Declarations of Applicant