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Student Declaration for the
IEEE Canadian Foundation Garganitini-Strybosch Scholarship

  Instructions to complete this form:       
  • The student nominee is to complete all sections of this form and submit electronically.
  • The nominee must be
    • a student member of IEEE (or agree to apply for membership),
    • enrolled as a full-time student and entering his or her second undergraduate year,
    • completing a Canadian university program in a field of interest to IEEE,
    • a Canadian citizen or permanent resident of Canada (verification may be requested prior to award)
  • The nominee is expected to demonstrate:
    • Brightness, in a broad well-rounded sense, not just academic course marks.
    • Integrity, the fundamental values of which are honesty, trust, fairness, respect, responsibility, courage, as well as trustworthiness. These values are central to the development and sharing of knowledge.
    • Engagement with their community, e.g. electrical and computer engineering, humanitarian use of technology, campus life, local, national or international community.
    • Commitment and enthusiasm for undergraduate study in fields of interest to IEEE.

 Step 1: Please identify yourself and your university or college
  1.1 Enter your full name (surname last)
  1.2 Enter your e-mail address
  1.3 Enter your student ID number (as assigned by your institution)
  1.4 Enter your university

  1.5 Enter your IEEE membership number
  1.6 If not yet an IEEE Member, if selected I will apply for Student Membership before receiving the Scholarship. Yes No
  1.7 Enter the full name (surname last) of the   faculty member who must complete and submit the on-line nomination form.
  1.8 Enter your faculty nominator's e-mail address
 Step 2: Submit your essay as described on the information page; max 500 words
  2.1 Certify that you are entering your second undergraduate year (a requirement): Yes No
  2.2 Certify that you are a first generation in the family university student: Yes No
  2.3 Insert your student declaration(essay) below. (Maximum 500 words; consider the four characteristics described in the instructions above.) ):
 Step 3: Submit your Declaration.
  Save a local copy and then submit your Declaration.
  Note 1: please send your local copy to your faculty nominator.
  Note 2: make sure that your faculty nominator submits the nomination form on your behalf.

NOTE: Form processing is temporarily unavailable. Please save the contents of this form after completion and email to the ICF Grants Committee.

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