PUBLIC HEALTH AND THE AGRICULTURAL RURAL ECOSYSTEM (PHARE)

Graduate Training Program CV MODULE

This table is for PHARE administrative use only. It will not be included in the evaluation of your application for funding. Family Name: Given Names:

Salutation: Dr. Mr. Mrs. Ms. Prof.

Citizenship:

Canadian Other

Permanent Resident

Country of citizenship if not Canadian: ___________________________________________________ Gender: Male Female Date of Birth (DD/MM/YYYY):

Research Project Title:

Mailing Address:

E-mail Address:

Telephone Number:

Expertise:
List up to 6 key words that best describe your expertise in research, instruments and techniques 1. 2. 3. 4. 5. 6.

Name:

Academic / Training Background

Indicate all university degrees obtained and those in progress (where applicable) starting with the most recent. If you hold a codegree from more than one institution (e.g. Soutien aux cotutelles de these de doctorat agreement between Quebec and France) enter each institution separately. Do not enter honorary degrees here, they should be listed in the Distinctions section. Indicate research training, such as postdoctoral or fellowship training. Do not include clinical training. Also list undergraduate and graduate research training experience.
Period of Study From Month Year Month To Year Institution / Organization & Country Discipline Graduated Received (Expected) Degree Year Supervisor

This CV Module was adapted from the CIHR CV Module. July, 2002. Updated January 2012.

Name:

Distinctions
Starting with the most recent, list the type and value of award, including salary and training awards, the name of the awarding organization and date awarded. No additional pages may be added.
Type and value Awarding Organization Date Awarded

This CV Module was adapted from the CIHR CV Module. July, 2002. Updated January 2012.

Name:

Credentials
In the space provided, list any qualifications, certificates and licenses completed, starting with the most recent.
Title Organization Start Date (MM/YYYY) End Date (MM/YYYY)

This CV Module was adapted from the CIHR CV Module. July, 2002. Updated January 2012.

Name:

Work experience
Start with the most recent, indicate your current position, where applicable, and other academic and non-academic position(s) since the beginning of your university studies. For your current positions leave the end date blank. No additional pages may be added.
Position Organization and Country Faculty and Department / School Start Date (MM/YYYY) End Date (MM/YYYY)

This CV Module was adapted from the CIHR CV Module. July, 2002. Updated January 2012.

Name:

Patents And Copyrights

There are two components to entry: total numbers of patents / copyrights; and detailed content. Record the total numbers of patents / copyrights in the following table. Details regarding the entries are to be attached within the Contributions.
IN CIRCULATION Total Individual Total Collective Sub-Total Total Individual IN PROGRESS Total Collective Sub-Total TOTAL PATENT / COPYRIGHTS

Publications
There are two components to entry: total numbers of publications; and detailed citations. Record the total numbers of publications in the following table. Citations for the entries are to be attached within the Contributions section.
Publications Refereed Papers Books and Monographs Book Chapters / Contributions to a collective work Abstracts / Notes Invited Presentations TOTALS

Already Published Accepted or in the press

0
0

This CV Module was adapted from the CIHR CV Module. July, 2002. Updated January 2012.

Name:

Classification Code Table - Areas of Research

Indicate and rank the 4 disciplines that best correspond to your research interests. _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____OTHER _____ ALT AGRIC BACT BIOAER BIOC BIOL BLOOD CANC CARD CELL CHEM DENT DRUG ECOS ENDO ENGIN EPID GENE GENO GEOL GEOG GLHLTH HEAR HSR IMAG IMMT MED MENT MICRO MOLB NURS NUTR POP PSB TOXIC VET VIRO WASTE WATER Alternative Medicine Agriculture Bacteriology Parasitology Bioaerosols Biochemistry Biology Blood-Hematology Cancer Cardiology Cell Biology Chemisty Dental Science Oral Biology Drug Research Ecosystems Endocrinology Engineering Community Health and Epidemiology Genetics Genomics, Proteomics and Bioinformatics Geology Geography Global Health Hearing Health Services Research Imaging Immunology Transplantation Medicine Mental Health Microbiology Molecular Biology Nursing Nutrition Population Health Psychosocial and Health Behavioral Research Toxicology Veterinary Medicine Virology Waste Management Water Please describe: ________________________________________________________ ______________________________________________________________________ 7

This CV Module was adapted from the CIHR CV Module. July, 2002. Updated January 2012.

ATTACHMENT INSTRUCTIONS Activities/Contributions, Interruptions/Delays, and Publications (Part 2) details shall be contained in a CV attachment. The following format should be adhered to for this attachment. 8.5 x 11 (21.5 x 28.0 cm) white single-sided paper Margins of (2 cm) Minimum font size 12 point or 10 characters per inch Six lines per inch, single-spaced, with no condensed type or spacing. Number pages consecutively after CV. Each page header must contain the name and the sub-section header. Activities / Contributions The activities and contributions defined in this section should include both academic and non-academic achievements, and their impacts. Limit the list to one page. Examples of entries follow. This is not necessarily a complete list, and is intended to provide guidance only. Career development (e.g. evidence of international leadership) Committee membership o For peer review committees, specify the year(s), the subject(s) and the funding organization o For thesis examination committees, indicate the author, title of thesis and university Consulting/contract activities Research development Research or technical reports Supervisory experience (e.g. training of students) Technology transfers (specify the nature of the activity and the target audience) Involvement in public, private, or non-profit sector activities Policy papers Public or Invited Lectures Editorships (specify if editor in chief or as a member of the editorial team) Evaluation of articles for scientific, literary or artistic journals ( specify title of journal and the number of articles evaluated) Knowledge Translation/Dissemination Activities Publications List your principal publications and presentations over the course of your career. Exclude period of interruptions.

This CV Module was adapted from the CIHR CV Module. July, 2002. Updated January 2012.