Mackey-Glass Summer Research Bursary

in Physiology

Student Last Name: Student First Name:

Student ID: Student Email:

Current Year and Program of Study: Student Department:

Supervisor Name: Supervisor Email:

Project Title:

Proposed Duration of Research (Number of weeks)

Outline of proposed Research Project:

Please provide a clear outline of the proposed work (no more than 300 words). Include a clear
description of the applicant's participation and activities (e.g. beyond the role of the lab
assistant/technician or programmer).
Personal Statement:

Please explain (no more than 300 words) why you are applying.

Applicant:

I declare that I will devote my full-time to working on the above research project during the
period of this award.

Signature: _______________________ Date: ___________________

Proposed Supervisor:

I declare that I will take this student under my supervision and undertake to pay 1/3 of the full
stipend for the first 12 weeks, as well as a full stipend in the same amount for any mutually-
agreed extension beyond this initial 12 week duration.

Signature: _______________________ Date: ___________________

Please forward this application along with your current transcript (unofficial copy will suffice) to
physiology.med@mcgill.ca .