Teaching and Learning Doctoral Completion Award (DCA)

2017-2018 Academic Year APPLICATION FORM DEPARTMENT OF CURRICULUM, TEACHING AND LEARNING DOCTORAL COMPLETION AWARD (DCA)

Applicants will also need to submit a ROSI printout of their transcript and a CV (3 pages maximum) TO BE COMPLETED BY THE APPLICANT Last Name: First Name:

Applicant’s Home Address:

Student Number: Department:  Canadian Citizen or Permanent Resident  Student Visa Did you interrupt your studies at any time to take a leave?  No:  Yes

I will begin/began my first non funded year on : ______(month/year) List any financial support you will receive in the 2017-2018 academic year. If you have confirmation that any award applications were successful, please list them here. Include fellowships, scholarships, grants, externals awards, RA or other stipends, TA, TEPA, including paid work outside of the university, i.e., substitute teaching, etc. 1.______$______3.______$______5.______$______

2.______$______4.______$______6.______$______List any financial support you have applied for (scholarships, awards, assistantships) that, if successful, you would receive in the 2017-2018 academic year. (I.e. you have not received confirmation yet). At the time of application deadline, the GA and TA positions have not been posted. They do not need to be included. 1.______$______3.______$______5.______$______2.______$______4.______$______6.______$______PLEASE ANSWER THE FOLLOWING QUESTIONS (IF NEEDED, YOU MAY CONTINUE ONTO THE NEXT PAGE). PLEASE DO NOT ATTACH ANY MATERIALS OTHER THAN THOSE REQUESTED. 1. Describe your progress and accomplishments to date (i.e. where you are in completing your program – field work, data analysis, writing draft of thesis, etc).

2. Are you in good academic standing? Did you achieve candidacy? If so, please indicate the date.

3. Estimate and describe the amount of work remaining to be done and expected date of completion.

4. Provide reasons why you have been unable to complete the above work within the timelines of the funding period provided to students in your graduate unit.

The University of Toronto respects your privacy. Personal information that you provide to the University is collected pursuant to section 2(14) of the University of Toronto Act, 1971. It is collected for the purpose of administering admission, registration, academic programs, university-related student activities, activities of student societies, safety, financial assistance and awards, graduation and university advancement, and reporting to government agencies for statistical purposes. At all times it will be protected in accordance with the Freedom of Information and Protection of Privacy Act. If you have questions, please refer to www.utoronto.ca/privacy or contact the University Freedom of Information and Protection of Privacy Coordinator at 416 946-7303, McMurrich Building room 104, 12 Queen’s Park Crescent West, Toronto, ON, M5S 1A8. 2017-2018 Academic Year APPLICATION FORM DEPARTMENT OF CURRICULUM, TEACHING AND LEARNING DOCTORAL COMPLETION AWARD (DCA) Applicant’s Signature: Date:  CV attached (3 page maximum)  ROSI Printout of Transcript

The University of Toronto respects your privacy. Personal information that you provide to the University is collected pursuant to section 2(14) of the University of Toronto Act, 1971. It is collected for the purpose of administering admission, registration, academic programs, university-related student activities, activities of student societies, safety, financial assistance and awards, graduation and university advancement, and reporting to government agencies for statistical purposes. At all times it will be protected in accordance with the Freedom of Information and Protection of Privacy Act. If you have questions, please refer to www.utoronto.ca/privacy or contact the University Freedom of Information and Protection of Privacy Coordinator at 416 946-7303, McMurrich Building room 104, 12 Queen’s Park Crescent West, Toronto, ON, M5S 1A8.