Institute of Medical Science UofT Open Fellowship Award ...

Please complete the application form below and submit to the IMS office no later than July 1 st .
Student Name:__________________________________________________
Student Number:_________________________________________________
Degree Program:_________________________________________________
Supervisor Name:________________________________________________
Funding for the upcoming year
Please estimate the amount of funding you will receive from each of the sources below:
External Award (OGS, CIHR Doctoral Award, etc.). Please specify:
$__________________ Award Name: _______________________________
$__________________ Award Name: _______________________________
$__________________ Award Name: _______________________________
Internal Award (OSOTF, OGSST, etc.). Please specify:
$__________________ Award Name: _______________________________
$__________________ Award Name: _______________________________
$__________________ Award Name: _______________________________
Supervisor stipend
$__________________
Verify and sign below indicating that eligibility requirements are met and funding information provided is
accurately reported at the time of application.
Student signature:______________________________________________ Date: ______________
Supervisor signature:____________________________________________ Date: ______________
APPLICATION DEADLINE: July 1st
(no late applications will be accepted)