Regional Graduate Student Scholarship Application Form

Regional Graduate Student Scholarship Application Form

Entry Deadline February 7, 2025
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.
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

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Date Signed and submitted

MonthDayYear
Date
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Post Secondary Education Record