ࡱ> {zi z\bjbj Cx{b{b H HH8=34@t ~w!L!(h2j2j2j2j2j2j2$57Z2i! " !!2HHM2 $ $ $!^H8h2 $!h2 $ $r-T.PxЯ{I"R-T2 30=3-/8"r/8../8D/!! $!!!!!22 $!!!=3!!!!/8!!!!!!!!! B : Laboratory Medicine & Pathology PhD Proposal Form Submission Date:  FORMTEXT        Student's Name:  FORMTEXT       Student ID:  FORMTEXT       Start Date of Program (mm/yr):  FORMTEXT       Title of Proposal:  FORMTEXT       Coursework List ALL coursework (completed, current, and planned) and indicate the grade if the course is complete, or the course status (in progress or planned) if not complete. Year/TermCourse Name, Number, and Title (e.g. LABMP 500 Introduction to Human Disease)Grade (if completed), or In Progress, or Planned FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       Ethics Training. Has ethics training been completed? Yes  FORMCHECKBOX  No  FORMCHECKBOX   FORMCHECKBOX  Ethics and Scientific Integrity Day (5 hours)  FORMCHECKBOX  Other (3 hours) e.g LABMP 530, LABMP 535, GET, etc. OR  FORMCHECKBOX  INT D 710  FORMCHECKBOX  INT D 720 Professional Development Requirement:  FORMCHECKBOX  Individual Development Plan (IDP)  FORMCHECKBOX  Professional development activities (8 hrs) List the graduate students: Awards, distinctions  FORMTEXT       Peer-reviewed publications  FORMTEXT       Presentations, abstracts  FORMTEXT       Other (e.g: patents, etc& )  FORMTEXT       Timeline. Indicate dates for: Supervisory Committee meetings (past meetings)  FORMTEXT       Candidacy exam  FORMTEXT       Final oral exam  FORMTEXT       Required documents:  FORMCHECKBOX  Proposal which has been completed independently by the student (submit electronic copy to  HYPERLINK "mailto:lmpgrad@ualberta.ca" lmpgrad@ualberta.ca)  FORMCHECKBOX  Written statement from the Supervisor on the potential contribution to science (maximum 200 words)  FORMCHECKBOX  Written statement from the Supervisor on his/her expertise and the expertise of the supervisory committee members (1-2 sentences per committee member), and the resources (facilities, equipment, personnel) available to support the students program  FORMCHECKBOX  Proposals must be accompanied by a list of five potential reviewers from @bdyhMh;* h[wMh[wMCJOJQJ^JaJ#h[wMh[wM5CJOJQJ^JaJ4jh1Ah1ACJOJQJU^JaJmHnHu h1Ah[wMCJOJQJ^JaJ4jhyh $LCJOJQJU^JaJmHnHu/jhyh $LCJOJQJU^JaJ)jhyh $LCJOJQJU^JaJ hyh $LCJOJQJ^JaJh[wM5CJOJQJ^JaJh $L5CJOJQJ^JaJh_ 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These reviewers must not be collaborators on the student s project. The list is to be submitted by the student's supervisor directly to the Graduate Studies Director at  HYPERLINK "mailto:LMPgrad@ualberta.ca" LMPgrad@ualberta.ca. Reviewers names are not be identified to the student.  I declare that the information given on this form is true and complete, and I understand it is subject to verification. Student s signature Date Approved to submit PhD Proposal to the Laboratory Medicine & Pathology Graduate Program. Signature of:Printed Name and Department/InstitutionDateSupervisor:  FORMTEXT      Supervisor:  FORMTEXT      Committee Member:  FORMTEXT      Committee Member:  FORMTEXT      Committee Member:  FORMTEXT       PhD proposal is approved to go to external review:  FORMTEXT       Graduate Studies Coordinator Signature Date     October 2021 Page |  PAGE \* MERGEFORMAT 2 The information on this form is being collected by the University of Alberta under the general authority of Section 32C of the Freedom of Information and Protection of Privacy Act. By signing this form you are consenting to the collection and use of this information by the University. 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