Visiting International Scholar/University Mentorship Application

Personal Information

Program(Required)
Name (exactly as written on passport)(Required)
MM slash DD slash YYYY
Email(Required)
Address(Required)

Institutional Information

Institution Address(Required)
Status at Home Institution(Required)

Visit Information

Purpose of Visit(Required)

MM slash DD slash YYYY
MM slash DD slash YYYY
Do you already have authorization to work in Canada (e.g. work permit, permanent resident)?(Required)
Academic Host/Supervisor at Brock(Required)
Has the academic host/supervisor agreed to your visit?(Required)

Funding Information

Source of Funding(Required)

Attachments

Accepted file types: pdf, Max. file size: 29 MB.
Accepted file types: pdf, Max. file size: 29 MB.
Please note that we require proof of funding prior to your arrival Brock University. If you're unable to upload proof now, please send it via email to globalscholars@brocku.ca prior to your arrival.
Accepted file types: pdf, Max. file size: 29 MB.
Accepted file types: pdf, Max. file size: 29 MB.
Accepted file types: pdf, Max. file size: 29 MB.
Please fill out the Liability Waiver Form and include it with your application. Download the Liability Waiver Form here
Accepted file types: pdf, Max. file size: 29 MB.
Accepted file types: pdf, Max. file size: 29 MB.
Please do not travel to Canada without authorization to work.

Privacy Statement

Brock University protects your privacy and your personal information. The personal information requested on this form is collected under the authority of The Brock University Act, 1964, and in accordance with the Freedom of Information and Protection of Privacy Act (FIPPA) for the administration of the University and its programs and services. Direct any questions about this collection to Brock International Services, at globalscholars@brocku.ca
This field is for validation purposes and should be left unchanged.