Quantum Graduate Visitor Program Application

Name*
First Last
Email*
Citizenship*
Present Educational Institution*
Current Supervisor*
Graduate Program*
Please indicate whether you are enrolled in a doctorate or masters program.
- Doctorate Program
- Masters Program
Proposed Start Date of Visit*
Note that visits must be less than 120 days. It is recommended that the application should be submitted at least two months prior to the proposed start date.
MM slash DD slash YYYY
Proposed End Date of Visit*
MM slash DD slash YYYY
Statement of Interest*
Please describe your research interests and explain why you wish to participate in this research program. Include the name of the project you are interested in working on or the name of the faculty you are interested in working with.
CV*
Drop files here or

Accepted file types: pdf, doc, docx, Max. file size: 5 MB.
Gender*
Select the option you identify with:
- Woman
- Man
- Gender-fluid, non-binary and/or Two-Spirit
- I prefer not to answer
Indigenous Identity*
Do you identify as Indigenous? Note: The Employment Equity Act defines Indigenous peoples as persons who are First Nations (North American Indian), Métis or Inuit.
- Yes
- No
- I prefer not to answer
If yes, select the options that you identify with
- First Nations
- Inuit
- Métis
- I prefer not to answer
Disabilities*
Do you identify as a person with a disability? Note: The Employment Equity Act defines persons with disability as persons who have a long-term or recurring physical, mental, sensory, psychiatric or learning impairment and: a) who considers themselves to be disadvantaged in employment by reason of that impairment; or b) Who believes that an employer or potential employer is likely to consider them to be disadvantaged in employment by reason of that impairment; and Includes persons whose functional limitations owing to their impairment may have been accommodated in their current job or workplace
- Yes
- No
- I prefer not to answer
Visible Minorities*
Do you / would you identify as a member of a visible minority in Canada? Note: Visible minority refers to whether a person belongs to a visible minority group defined by the Canada Employment Equity Act. The Act defines visible minorities as "persons, other than Aboriginal peoples, who are non-Caucasian in race or non-white in colour"
- Yes
- No
- I prefer not to answer
If yes, select the options you identify with*
- Select All
- Arab
- Black
- Chinese
- Filipino
- Japanese
- Korean
- Latin American
- South Asian (e.g., East Indian, Pakistani, Sri Lankan, etc.)
- Southeast Asian (including Vietnamese, Cambodian, Laotian, Thai, etc.)
- West Asian
- I prefer not to answer
External Funding
Please indicate if you have any funds (such as travel grants) that you plan to contribute to the funding of your visit. Please note that ability to contribute funds is not part of the criteria used for selection.

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Quantum Graduate Visitor Program Application

Quantum Graduate Visitor Program Application