The University of British

Columbia
GENOME SCIENCE + TECHNOLOGY GRADUATE PROGRAM

Application Form
Last name (family name):

First name (personal name):

Sex:

Date of birth:

Male

Female

Postal Address:

E-mail address:

Telephone:

If applicable, list any other names on your educational records:

Citizenship:
Do you intend to apply to a medical school within a year of submitting this application?
Yes
No
Are you applying for an NSERC-CREATE scholarship?

Yes

No

Have you applied for outside external scholarships (i.e. NSERC, CIHR, MSFHR)?
Yes
No If yes, which one?
Previous Degree(s):

1) Briefly describe why you are applying to the Genome Science & Technology
graduate program, and your career objectives for attaining a degree. Use a maximum
of 2 pages.
2) Briefly discuss your background in the life sciences. Information should be provided
about academic experience, work experience and any other factor that may be of
assistance to the Admission Committee. Use a maximum of 2 pages.
3) Briefly discuss your background in the quantitative sciences (mathematics, statistics,
computer science, engineering). Information should be provided about academic
experience, work experience and any other factor that may be of assistance to the
Admission Committee. Use a maximum of 2 pages.
4) List the names of Genome Sciences & Technology Graduate Program faculty whose
research is of interest to you, and briefly describe your interest. Be sure to mention
January 2012

any research interests or relevant experience you have which may parallel or touch
upon the research of faculty.
5) List your recent honours, awards and any publications.
6) List employment/work experience related to your proposed course of study.
Position:

Employer:

Dates, from/to:

Nature of work:

Name and contact information for a reference within the company:

Position:

Employer:

Dates, from/to:

Nature of work:

Name and contact information for a reference within the company:

7) Please make arrangements for three strongly supportive letters of reference to be

written on your behalf. They can either be sent directly from the Reference or enclosed
in a sealed envelope with the Referees signature across the seal.
Please provide the names, institutions and email addresses of individuals asked to write
letters of recommendation:
Name

Institution

Email

8) Official transcripts from all post-secondary institutions attended. These can either be
sent directly from the institution or enclosed in a sealed envelope.
9) For students whose first language is not English or have not attended an Englishspeaking post-secondary institution, please provide official TOEFL score. (Use
University code: 0965 Dept. code: 99). Minimum scores for Tests of English as a
Foreign Language:
January 2012

TOEFL (internet-based) overall score of 100

MELAB 87-88
IELTS overall band 7

Additional information: Please submit any additional information regarding your

educational or employment history, proposed research, or any other factors that you think
will bear upon your admission. Use a maximum of 2 pages.

Complete and submit this application form to the GSAT Program Coordinator (preferably
electronically to sharonr@bcgsc.ca) prior to the admissions deadline. Supporting
documentation can be sent by postal mail.
When we receive your transcripts, letters of reference and completed application form,
we will open a file for your application and send it to our Admissions Committee.
Genome Science + Technology Graduate Program Coordinator
100-570 West 7th Avenue
Vancouver, BC V5Z 4S6
Tel: (604) 707-5803
Fax: (604) 876-3561

January 2012