Education Research Grant Application Form

Thank you for your interest in the Education Research Grant. Please fill out the required information below.

Ensure that all documents are submitted in PDF format and contain no special characters in the file name, including punctuation.

NOTE: This online form must be completed in one single session. This form cannot save your information to return to at a later time.

Primary Applicant Details

First Name

Last Name

Institution

Phone

Are you currently a CAG Member?

Yes No

Curriculum Vitae

Canadian Practice Intention Statement

Co-Applicant Details

Co-Applicant First Name

Co-Applicant Last Name

Co-Applicant Institution

Co-Applicant Phone Number

Co-Applicant Email

Proposal Details

Applications must meet contemporary standards of educational research, which include the relevance of the research question, quality of research design, appropriateness of the proposed budget and the ability to complete the project in the specified time period.

Preference will be given to applicants with a dedicated trainee to the project, preferably a GI fellow. Consideration will be given to applicants with interested trainees at all levels with an interest in gastroenterology.

Proposals should note how the applicant plans to mentor the trainee and comment on the educational/research environment and access to preceptors. Proposals should not exceed 3 pages, font size 12pt, with 1-inch margins. This does not include Appendices (references, figures, tables).

Proposal Title

Proposal

Budget

Commitment from Department Head

Department Head First Name

Department Head Last Name

Department Head Phone Number

Department Head Email

Letter of Support

Electronic Signature

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Yes

Full Name

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