Innovation 601 E-Course Application Form

Please complete the following application form and submit to THECIS by clicking the "Submit Application" button at the bottom. We will not accept applications sent by email.

Name
Mailing Address
Phone Number
Email
Your institution
Your degree program
Your area of research interest
Your most recent (e.g. grad school) GPA [no transcript required]
Gender:	Male Female
For current or former University of Calgary students, please provide your UCID number

Have you contacted your supervisor and advised them of your application and confirmed they have agreed to you attending if accepted: Yes No

Please in 100 words or less explain why you would alike to attend Innovation 601

I understand, that if accepted, I am responsible to get to the BGS Institute: Barrier Lake Field Station, (The U of C’s Barrier Lake Field Station is located on Highway 40, 10 km south of the Trans Canada Highway (west of Calgary). Turn off the Trans Canada Highway onto Highway 40, then watch for the Barrier Lake Station sign just past “Barrier Dam Day Use Area.”) Yes No

I understand that, if accepted, I will provide a cheque for $200 made out to "THECIS" dated November 5, 2010. Yes No

I give my permission to share my email contact information with the other participants of this course. Yes No

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