Science Meets Parliament 2021 – Application

Thank you for your interest in Science Meets Parliament 2021. Unfortunately, you are not eligible to apply for the program at this time. For more information, contact: sciencemeetsparliament@sciencepolicy.ca

Application Form: Science Meets Parliament 2021 (SMP 2021)

CSPC reserves the right to nominate researchers from Indigenous communities in order to have their representation in this program.

Official Name *

Preferred Name *

Will you be engaging with Parliamentarians in English or French? *
---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.

Select the option that best describes your current gender identity *
---WomanManGender-fluid,non-binary, and/or Two-SpiritI don’t identify with any option providedI prefer not to answer

Do you identify as Indigenous, that is, First Nation (North American Indian), Métis, or Inuk (Inuit)? *
---Yes - First NationsYes - InuitYes – MétisNoI prefer not to answer

Do you identify as a person with a disability? *
---YesNoI prefer not to answer

Note: Person with a disability is a person who has a long-term or recurring physical, mental, sensory, psychiatric or learning impairment and:

• Who considers themselves to be disadvantaged in employment by reason of that impairment, or
• 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.

The Employment Equity Act defines visible minorities as "persons, other than Aboriginal peoples, who are non-Caucasian in race or non-white in colour". Do you identify as a member of a visible minority in Canada? *
---YesNoI prefer not to answer

Please identify the granting agency through which you have received your research chair Tier 2 funding *
---Canadian Institutes of Health ResearchNatural Sciences and Engineering Research CouncilSocial Sciences and Humanities Research CouncilN/A

Home Institution / Organization *

Faculty / Department *

Title / Role *

Work Address *

City *

Province *

Email *

Telephone *

Twitter Handle

Biography *Please note, your biography may be published if you are selected.

Please describe your current research focus and collaborations, and why they are important *Please note, this may be used in preparing briefing materials if you are selected.

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.

Why do you think the Science Meets Parliament initiative is important for academics, parliamentarians, and the country? *

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

Who is your local (residential) Member of Parliament (MP)? *http://www.ourcommons.ca/Parliamentarians/en/members

Who is the Member of Parliament (MP) for your institution? *

How did you hear about Science Meets Parliament? *
---Social MediaNewsletterCSPC WebsiteFriendsOther, Please Specify

Would you like to receive communications about other news and opportunities from CSPC and the Office of the Chief Science Advisor? *
---Yes, please share my email!I am already receiving information from themNo, I do not wish to receive more information