CSIN Student Application Form

Prospective Collaborative Specialization In Neuroscience (CSIN) students may fill in and submit the application form below.

Before being admitted into CSIN, a student must be registered in a participating graduate unit.
Students must meet all program requirements in order to graduate with the CSIN Notation on their transcript, no exceptions.
All applications must include the completed CSIN Student Application Signature Page.

To ensure that the form has been received by us, please wait for a confirmation message upon submission.

Student Information

First Name*

Last Name:*

I identify my gender as:

I identify as:

Student Number:*

Department:*

Degree Program:

SGS Registration Date:*

Student E-mail Address:*

Title/Topic of Research:*

Expected length of study (years):*

Supervisor's Name:*

Supervisor's E-mail Address:*

Please upload your CV in PDF format:*

One file only.
10 MB limit.
Allowed types: pdf.

Lab Address

Address*

Institution*

City*

Province*

Postal Code*

Phone Number*

Home Address

Address*

City*

Province*

Postal Code*

Phone Number*

Other Comments

Please attach your completed CPIN Student Application Signature Page in PDF format (see above for download link):*

One file only.
10 MB limit.
Allowed types: pdf.

If you do NOT wish to be listed on the CPIN website, please check box: