Regional Graduate Student Scholarship Application Form

Regional Graduate Student Scholarship Application Form

Entry Deadline January 29, 2027
Your Name

First NameMiddle NameLast Name
Your Email
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
CEGA Membership Number
Post Secondary Education Record

(start with current studies)
Period of Study - start date Date, end date Date .
Name of Institution Discipline . Degree Obtained . Graduation Date Date .
Period of Study - start date Date, end date Date .
Name of Institution Discipline . Degree Obtained . Graduation Date Date .
Period of Study - start date Date, end date Date .
Name of Institution Discipline . Degree Obtained . Graduation Date Date .
Thesis Title
Thesis Supervisor(s)
Anticipated finishing date
Financial and/or in-kind support, if any, for thesis.
List of Scholarships or Distinctions already won.
List of Publications, if any, in refereed journals.
List of publications, if any, in unreferred journals.
File Upload - For Supervisor Reference Letter

Supervisor Letter may be submitted separately to studentawardthesis@cegageos.ca
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File Upload - For Thesis Outline

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Signature
Date Signed and submitted

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Should be Empty:

Post Secondary Education Record