name: Professor’s Establishment: We certify that this person was hired as a professor and will work exclusively or almost exclusively in the field of science and engineering, finance, health, or new information and communications technologies for the establishment mentioned above from the date he or she was hired until the end of his or her employment contract. We undertake to inform the de of any change to the employment situation. Ministère de l’Éducation et l’Enseignement supérieur professor’s Date of signing of employment contract (YYYY-MM-DD): applicant’s Start date of applicant’s contract (YYYY-MM-DD): End date of applicant’s contract (YYYY-MM-DD): 6 Research field – Field of research: Code: Brief description of field of research (attach a separate sheet of paper if necessary): applicant’s Department or affiliated research centre: 7 Signatures – We declare that the information provided in this application is accurate and complete. signature: Date (YYYY-MM-DD): Applicant’s Signature of the designated representative Date (YYYY-MM-DD): of the eligible university: You must attach the following documents to this application form: a copy of a document confirming the appointment as a professor employed by the eligible university applicant’s a certified true copy of the doctoral (Ph.D.) degree or equivalent recognized by the university applicant’s a copy of the abstract (summary) of the doctoral (Ph.D.) thesis applicant’s the job description and list of duties applicant’s a copy of the up-to-date curriculum vitæ applicant’s a copy of the work permit issued by Citizenship and Immigration Canada applicant’s The application for a certificate and all required supporting documents must be mailed to: Direction de l'enseignement et de la recherche universitaires Direction générale des affaires universitaires et interordres Ministère de et de l’Éducation l’Enseignement supérieur 1035, rue De La Chevrotière, 18e étage Québec (Québec) G1R 5A5
Professor’s name: Establishment: We certify that this person was hired as a professor and will work exclusively or almost exclusively in the field of science and engineering, finance, health, or new information and communications technologies for the establishment mentioned above from the date he or she was hired until the end of his or her employment contract. We undertake to inform the Ministère de l’Éducation et de l’Enseignement supérieur of any change to the professor’s employment situation. Date of signing of applicant’s employment contract (YYYY-MM-DD): Start date of applicant’s contract (YYYY-MM-DD): End date of applicant’s contract (YYYY-MM-DD): 6 – Research field Field of research: Code: Brief description of applicant’s field of research (attach a separate sheet of paper if necessary): Department or affiliated research centre: 7 – Signatures We declare that the information provided in this application is accurate and complete. Applicant’s signature: Date (YYYY-MM-DD): Signature of the designated representative of the eligible university: Date (YYYY-MM-DD): You must attach the following documents to this application form: a copy of a document confirming the applicant’s appointment as a professor employed by the eligible university a certified true copy of the applicant’s doctoral (Ph.D.) degree or equivalent recognized by the university a copy of the abstract (summary) of the applicant’s doctoral (Ph.D.) thesis the applicant’s job description and list of duties a copy of the applicant’s up-to-date curriculum vitæ a copy of the applicant’s work permit issued by Citizenship and Immigration Canada The application for a certificate and all required supporting documents must be mailed to: Direction de l'enseignement et de la recherche universitaires Direction générale des affaires universitaires et interordres Ministère de l’Éducation et de l’Enseignement supérieur 1035, rue De La Chevrotière, 18e étage Québec (Québec) G1R 5A5
Formulaire_Demande_prof_VA.docx