form-visitors-program-2016

VISITORS PROGRAM
Application Form 2016
Application deadline : June 30, 2016
Please complete this form and return to the email address below. If you need assistance with completing the
form, please do not hesitate to contact us.
Email: marie-josee.lapointe@hec.ca
Phone: 1-514-340-6982
Erase data
PERSONAL DETAILS
Family name
Date of birth
First name
dd-mm-yyyy
Gender
Citizenship
Male
Female
CORRESPONDENCE ADDRESS
Street address
Postal code
City
Phone
State/Province
Email
Country
ACADEMIC DETAILS
Your home university
Position
Year of PhD completion
yyyy
Starting date
dd-mm-yyyy
Finishing date dd-mm-yyyy
Research project at the Centre (2 or 3 lines)
FUNDING SOURCES
Have you applied for funding to undertake your research stay at the Centre?
Yes
No
If yes, please indicate which funding sources you have applied to (institution, country):
Applications should include:
A letter of motivation from the candidate’s home institution or supervisor
A curriculum vitae and, if available, a list of publications
A letter of motivation stating the reasons for the application
A brief summary and work plan of the research project
Desired dates of stay
A copy of your passport
Please send back this completed form along with your documents in PDF format by
email to marie-josee.lapointe@hec.ca before June 30, 2016. Only completed applications will be considered.
THANK YOU FOR YOUR APPLICATION!
For questions regarding the application procedures or any other aspect of the Visitors Program, please visit
our website: financecoop.hec.ca
or contact us
by email marie-josee.lapointe@hec.ca
or by phone: 1-514-340-6982