Register - Cantrain

REGISTRATION

PERSONAL INFORMATION

Salutation

First Name*

Last Name*

E-mail Address*

Password*

Confirm Password*

A combination of one lowercase letter, one uppercase letter, and one number. Minimum length 8 characters.

Preferred language of correspondence**

EnglishFrançais

Country of residence*

Province

State

Citizenship Status*

Please read the guidelines for the program of your interest

Newsletter

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Do you want to start to fill your application now?

YesNo, I will return later to complete my application

CANDIDACY

You are applying as:

A Clinical Research Professional (CRP)An Early Career Researcher (ECR)

A Graduate and Postdoctoral Trainee (GPT)

Select one CTTP for an application:*

CANTRAIN (CRP)CAN-TAP-TALENT (CRP or ECR) (NOW CLOSED)

STROKECOG (CRP, ECR or GPT)

How long have you been in the specified role?

Select the type of institution(s) you are affiliated with (select all that applies)

Academic or Healthcare InstitutionsResearch Centers or Institutes

Regional or District Health AuthoritiesHospitals

Non-for-Profit or Community OrganizationsOther

Please specify your primary institution / affiliation

1. Personal Statement

Briefly describe how your project and internship is related to your current work as a Clinical Research Professionals (CRP) / Early Career Researchers (ECR) / Graduate and Postdoctoral Trainees (GPT):

Briefly describe why the Clinical Trial Training Programs (CTTP) you selected is of interest to you and how you expect to benefit from this training experience:

Describe your current training environment and supervisory support:

Describe your professional, academic and extracurricular experiences / achievements and how they will contribute to your training success

Outline your career goals and describe how the award would help to support your pursuit of these goals.

If applicable, reflect on barriers that you as a member of an underrepresented group in science or research have experienced thus far and ways that you have sought to overcome these barriers. Describe how would the present award support you to overcome barriers relative to equity, diversity and inclusion?

I am currently working in health research and/or clinical research and do not have the training and experience to work in regulated clinical trials.

YesNo

I am currently working in clinical trials and looking to enhance my experience/skills in at least one of the following areas: (select all that apply).

Monitoring trialsQuality management

Decentralized trialsCulturally safe trials

Vulnerable populationsInstitutional sponsored or investigator led trials

Phase I, II, III, IV trials conductOther

2. Letter of Support

Name of your department head / direct supervisor

E-mail of the department head / direct supervisor

Letter of Support SIGNED by the department head or direct supervisor of the applicant

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Letter of Support SIGNED by the department head or direct supervisor of the applicant

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3. Curriculum Vitae

Curriculum Vitae: Regular CV or CCV

Upload Max:1000 Words

Curriculum Vitae: Regular CV or CCV

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If you have alternative achievements in addition to traditional academic achievements, please list and describe them (up to 2 additional pages)

Visit: Declarations of Research Assessment (DORA; https://sfdora.org/).

4. Internship / Clinical Research Practicum description

Enumerate and briefly elaborate your practicum goals / objectives.

Impact and Expected Outcomes: Elaborate expected results, deliverables and dissemination plan for your proposed project

Feasibility and Timelines: Demonstrate scientific and technical feasibility of additional skill development during the internship (e.g., recruitment of patients, acquisition of data, biostatistics, access to necessary equipment, etc.). Identify potential limitations and describe mitigation strategies. Describe timelines and milestones. Where the proposed project relies on existing resources (e.g., databases, established research infrastructure, equipment), describe the availability of these resources at the hosting institution where you will conduct the internship

Define your role during the internship at the welcoming / host institution

5. Letter of invitation/support

Have you identified your internship site at a welcoming/ hosting institute?

YesNo

Invitation letter from welcoming/hosting institute is required to proceed further in the application. If you need assistance to identify a welcoming/hosting institute, we invite you to contact the CTTP you are preparing to apply to for your internship at this link CRPinternships

Have you secured an internship invitation letter?

YesNo

Invitation letter from welcoming / hosting institute is required to proceed further in the application

Name of the member of welcoming / hosting site leadership providing letter of invitation

Email of the member of welcoming / hosting site leadership providing letter of invitation

Name of welcoming / hosting site internship-contact person / direct supervisor

Email of welcoming / hosting site internship-contact person / direct supervisor

Letter of invitation / support SIGNED by the institution leadership that will host and be accountable for welcoming you (the applicant). The welcoming site must have been in operation for at least 3 years and which includes clinical research / trials expertise

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SELF-DECLARATION**

Gender Identity

Gender fluidMan

NonbinaryTrans man

Trans womanTwo-Spirit

WomanNot specified above

Prefer not to answer

Sexual Orientation

AsexualBisexual

GayHeterosexual

LesbianPansexual

QueerTwo-Spirit

Not specified abovePrefer not to answer

Do you identify as a person with a disability?

YesNo

Prefer not to answer

Do you identify as an indigenous person ? (check all that apply)

Yes, First NationsYes, Inuk (Inuit)

Yes, MétisNo

Do not knowPrefer not to answer

Which category(ies), best describes you? (check all that apply)

ArabBlack

ChineseFilipino

JapaneseKorean

Latin AmericanSoutheast Asian

West AsianWhite

OtherPrefer not to answer

**Information regarding self-identification data collection in support of equity, diversity, and inclusion

SIGNATURE

Signature*

Date*

I certify that all questions have been answered in full and the information provided is correct and complete. I understand that completion of this signed application permits CANTRAIN to request and/or confirm any information necessary to support my application for admission. That submission of any false statements documents will result in the immediate and permanent cancellation of admission or registration to the CANTRAIN student and fellowship programmes that failure to attend a post-secondary institution during the year of the fellowship will lead to cancellation of this application.

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I confirm that the welcoming / hosting site has been in operation for at least 3 years and includes clinical research / trials expertise

I confirm that the letter of support and the invitation letter are on their respective institution letter heads and are signed

Do you want to submit your application now?

Yes, I want to close my application and submit itNo, I will return later to complete my application

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