No.
FORM Reference 202 Application for an Undergraduate Student Research Award PART I. Personal Data To be completed by student
Given name
Date
Family name of student
Initial(s) of all Personal Identification no. (PIN) given names
ACADEMIC BACKGROUND (including ongoing postsecondary degree) Degree Name of discipline Institution Department
Year and month of expected degree completion
At the time of application, are you attending university full time? part time?
Have you ever applied to NSERC in the past? Yes No
How many academic terms will you have completed towards your degree program when this award is held?
SCHOLARSHIPS AND OTHER AWARDS RECEIVED (start with most recent and include NSERC awards) Name of award Location of tenure Period held (yyyy/mm - yyyy/mm)
OTHER INFORMATION
Citizenship Canadian citizen Language of correspondance English French Permanent resident date (indicate of landing as stated on official immigration document) Optional Information (Refer toThe Access to Information Act and The Privacy Act) Gender Male Current address Female Designated group Aboriginal
Permanent mailing address (if differerent from current address)
If current address is temporary, indicate leaving date
Telephone number at permanent mailing address
Telephone number at current address
E-mail address
SIGNATURE (Refer to instructions "What does my signature on the application mean?")
I hereby agree to abide by NSERC regulations governing awards, as described in the NSERC Program Guide for Students and Fellows. Form 202-1 (2009 ) Personal information collected on this form and appendices will be stored in the Personal Information Bank for the appropriate program. Student Version franaise disponible
PROTECTED WHEN COMPLETED