SSEP Application Part 1: Student Section SECTION 1: APPLICANT INFORMATION Applicant Name: Email Address: Mailing Address: Best phone to reach you: Date of Birth (mm/dd/yyyy): Name of High School: MCP and SIN - Please note that upon hiring an MCP number and Social Insurance Number (SIN) will be required from successful applicants. Students who do not have a SIN upon notification of acceptance will not be accepted. Please do not include them on this application. Are you a resident of Canada? YesNo What grade level are you currently completing? Level 2 (Grade 11)Level 1 (Grade 10) - Labrador students only Do you have any health concerns, accessibility requirements or other information we should know about? (I.e. allergies, medical requirements) OPTIONAL Your answers, or your choice to leave this question unanswered, will have no effect on your application. Please check any that apply to you. IndigenousVisible Minority SECTION 2: APPLICANT INTERESTS What are your educational and career aspirations for the future? Please indicate the subjects you are most interested in: Fisheries: —Please choose an option—Very InterestedSomewhat InterestedNot Interested Forestry: —Please choose an option—Very InterestedSomewhat InterestedNot Interested Ecology: —Please choose an option—Very InterestedSomewhat InterestedNot Interested Geology: —Please choose an option—Very InterestedSomewhat InterestedNot Interested Geography: —Please choose an option—Very InterestedSomewhat InterestedNot Interested Physics: —Please choose an option—Very InterestedSomewhat InterestedNot Interested Chemistry: —Please choose an option—Very InterestedSomewhat InterestedNot Interested Biology: —Please choose an option—Very InterestedSomewhat InterestedNot Interested Mathematics: —Please choose an option—Very InterestedSomewhat InterestedNot Interested Engineering: —Please choose an option—Very InterestedSomewhat InterestedNot Interested Medicine: —Please choose an option—Very InterestedSomewhat InterestedNot Interested Education: —Please choose an option—Very InterestedSomewhat InterestedNot Interested Community Outreach: —Please choose an option—Very InterestedSomewhat InterestedNot Interested SECTION 3: PERSONAL STATEMENT The Personal Statement will help us to understand why you think a WISE Student Summer Research Placement would be of benefit to you and your future career goals. This Statement should be a maximum of two pages. Include your interests, groups and activities you may be involved in and why they may be relevant to your application for WISE SSEP. This statement is an important part in the assessment of your application so show us your enthusiasm and personality! You may handwrite or type your statement. Insert statement here SECTION 4: JOB PLACEMENT SELECTION Job Placement Ranking Use the “Job Descriptions” to select the WISE SSEP placements that most interest you. Your response will help us match you with an available position. NOTE: (2) indicates 2 available positions. All positions are subject to change as they are dependent upon the funding and supervision available. AVALON PENINSULA (42) 1. Research Assistant (Dr. Kelly Hawboldt) —Please choose an option—interestedSomewhat interestedNot interested 2. Design Assistant (Lihong Zhang) —Please choose an option—interestedSomewhat interestedNot interested 3. Annotation Specialist (Qian Zhong) —Please choose an option—interestedSomewhat interestedNot interested 4. Laboratory Assistant (Syed Imtiaz) —Please choose an option—interestedSomewhat interestedNot interested 5. Research Assistant (Lesley James) —Please choose an option—interestedSomewhat interestedNot interested 6. Data Collection Assistant (Sima Alidokht) —Please choose an option—interestedSomewhat interestedNot interested 7. SciQuest Camp Counselor (2) (Danielle Nichols) —Please choose an option—interestedSomewhat interestedNot interested 8. Atlantic Puffin Research Assistant (Dr. Pierre-Paul Bitton) —Please choose an option—interestedSomewhat interestedNot interested 9. Research Assistant (2) (Ashlyn Swift-Gallant) —Please choose an option—interestedSomewhat interestedNot interested 10. Student Research Assistant (2) (Heath Matheson) —Please choose an option—interestedSomewhat interestedNot interested 11. Research Assistant (2) (Dr. Lindsay Cahill) —Please choose an option—interestedSomewhat interestedNot interested 12. Research Assistant (Myongin Oh) —Please choose an option—interestedSomewhat interestedNot interested 13. Research Assistant (Erika Merschrod) —Please choose an option—interestedSomewhat interestedNot interested 14. Research Assistant (Hilding Neilson) —Please choose an option—interestedSomewhat interestedNot interested 15. Geochemistry Research Assistant (Michael Babechuk) —Please choose an option—interestedSomewhat interestedNot interested 16. Research Assistant in Paleoenvironments (Hilary Corlett) —Please choose an option—interestedSomewhat interestedNot interested 17. Computational Biochemistry Research Assistant (Dr. Katie Wilson) —Please choose an option—interestedSomewhat interestedNot interested 18. Research assistant in antimicrobial drug development (Valerie Booth) —Please choose an option—interestedSomewhat interestedNot interested 19. Nutritional Sciences Research Assistant – wet lab projects (Scott Harding) —Please choose an option—interestedSomewhat interestedNot interested 20. Public Health Research Assistant – Computer-based Projects (Scott Harding) —Please choose an option—interestedSomewhat interestedNot interested 21. Research Assistant in marine microbiology (Jeanette Wheeler) —Please choose an option—interestedSomewhat interestedNot interested 22. Molecular cell biology and developmental genetics laboratory assistant (Brian E. Staveley) —Please choose an option—interestedSomewhat interestedNot interested 23. Microbiology lab assistant (Dawn Bignell) —Please choose an option—interestedSomewhat interestedNot interested 24. Clinical Research Assistant - Cardiovascular Sciences (2) (Anthony Incognito) —Please choose an option—interestedSomewhat interestedNot interested 25. Marine Biology and Ecology Research Assistant (Patrick Gagnon) —Please choose an option—interestedSomewhat interestedNot interested 26. WISE Website Content Developer (2) (Melissa Keats) —Please choose an option—interestedSomewhat interestedNot interested 27. Science Interpreter (2) (Andrea van Nostrand) —Please choose an option—interestedSomewhat interestedNot interested 28. Nursery Research Assistant (Timothy Walsh) —Please choose an option—interestedSomewhat interestedNot interested 29. Aquarium Interpreter (Dr. William Driedzic) —Please choose an option—interestedSomewhat interestedNot interested 30. STEM Program Designer (2) (Jon Butler) —Please choose an option—interestedSomewhat interestedNot interested 31. Laboratory Technician (2) (Lana Cameron and Suzette Winter) —Please choose an option—interestedSomewhat interestedNot interested 32. Human Factors Research Assistant (Jennifer Smith) —Please choose an option—interestedSomewhat interestedNot interested 33. Research Assistant (Fatima Jahre) —Please choose an option—interestedSomewhat interestedNot interested WESTERN NEWFOUNDLAND (7) 34. Physics Outreach Student Coordinator (2) (Dr. Svetlana Barkanova) —Please choose an option—interestedSomewhat interestedNot interested 35. Research Assistant (Kelly Hawboldt) —Please choose an option—interestedSomewhat interestedNot interested 36. Research Assistant (2) (Mumtaz Cheema) —Please choose an option—interestedSomewhat interestedNot interested 37. Student Apprentice in the Makerspace (Dr. Todd Hennessey) —Please choose an option—interestedSomewhat interestedNot interested 38. Marine Interpreter/Cashier (Jill McCue-Laing) —Please choose an option—interestedSomewhat interestedNot interested LABRADOR (2) 39. Junior Food Researcher (Roxanne Notley) —Please choose an option—interestedSomewhat interestedNot interested Job Placement Ranking The Selection Committee will try to place you with the Job that interests you the most based on your Job Preferences top 3 choices. Please rank your choices by listing the Job number and title below: (For example: “12. Research Assistant”) First Choice: Second Choice: Third Choice: SECTION 5: ADDITIONAL REQUIREMENTS Grades A copy of your most recent grades must be included. For applications submitted online, instructions will be included in the acknowledgement message that is sent to the applicant after clicking the “Submit” button. For email or postal mail, a copy must be attached to the email message or included in the mailed envelope. Teacher References Two teacher references are required. Please indicate who will be providing references for you. Name of Teacher Reference #1: Name of Teacher Reference #2: Time Commitment Are planning on missing more than 3 days of work? YesNo If yes, please explain: Residence During the SSEP employment period, do you plan to live with somewhere other than with your parent or guardian? YesNo