SMP NWT 2027 – Application

Thank you for your interest in Science Meets Parliament - Northwest Territories 2027. Unfortunately you are not eligible to apply for the program at this time. For more information, contact: [email protected]

Application Form: Science Meets Parliament - Northwest Territories 2027 (SMP-NWT 2027)

Official Name *

Preferred Name *

Gender *
—Please choose an option—ManWomanNon-binaryPrefer not to sayPrefer to self-declare:

Will you be engaging with Parliamentarians in English or French? *
Please only indicate Both if you are comfortable speaking with Parliamentarians in both English and French.

—Please choose an option—EnglishFrenchBoth, English and French

The self-identification data collected in this form will only be used to help us achieve our goal of promoting diversity and representation among the delegation, and will be permanently deleted once the application process is complete.

Do you identify yourself with any of the equity seeking groups (check all that apply): *
First Nations, Inuit, or MetisBlackNon-indigenous, non-Black racialized community of CanadaLGBTQ2+A person with disabilityI prefer not to answerI don't identify with any of these groupsOther group, please specify:

Please identify the granting agency through which you have received your research chair Tier 2 funding or Tri-agency-funded Fellowship or whose mandate best captures your current research*

Social Sciences and Humanities Research CouncilNatural Sciences and Engineering Research CouncilCanadian Institutes of Health Research

Home Institution / Organization *

Faculty / Department *

Title / Role *

Date of initial appointment (month and year):*

City *

Province/Territory *

Email *

Telephone *

Social media handle

Please upload the signed letter of support from your research institution:
This letter should be signed by a representative in your research and innovation office or equivalent. The fillable letter of support can be found here.*

pdf or doc/docx file only

Biography (100 words maximum):*Please note, your biography may be published if you are selected.

Please describe your current research focus and its importance to the advancement of science and the public at large. *Please note, this may be used in preparing briefing materials if you are selected.

Please describe how your research aligns with the priority focuses in the NWT Knowledge Agenda *

How would you describe your research to a Parliamentarian who may not have a scientific background? *Please note, this may be used in preparing briefing materials if you are selected.

Please explain how this experience may enrich your professional work as a researcher. *

How would your participation in this program benefit Parliamentarians? *

How do you think this program impacts the broader scientific and political communities? *

Participants will be required to present a lecture about their experience at their home institution, or to detail their experience in a CSPC Featured Editorial. Please select your preferred method for dissemination. *
—Please choose an option—CSPC-Featured EditorialLecture at your home institutionBoth

Please describe any other means you will pursue to share insights and experiences gained from this program with your network and audience. *

If residing in the Northwest Territories, who is your local (residential) Member of the Legislative Assembly – Northwest Territories (MLA)? https://www.ntlegislativeassembly.ca/members/members-legislative-assembly/members

If residing in the Northwest Territories, who is the Member of the Legislative Assembly – Northwest Territories (MLA) for your institution?

How did you hear about Science Meets Parliament – Northwest Territories? *
—Please choose an option—Social MediaNewsletterCSPC WebsiteFriendsOther, Please Specify:

Can we add you to the CSPC mailing list? *
—Please choose an option—Yes, please add me!I am already on this list.No, I do not wish to be added to this mailing list.

Are there any other comments you wish to share with the committee?