Postdoctoral Scholar Appointment Form

Postdoctoral scholars are integral members of the university community and contribute extensively to Western's research output. To become a postdoctoral scholar at Western you must first contact a researcher at Western that shares your research interests and can therefore serve as your supervisor or mentor. For a complete overview of the steps necessary to become a Postdoctoral Scholar at Western, please browse our New Postdoctoral Scholar Checklist. Once you have attained an agreement in principle, the following form will inform Western of you and your potential supervisor's or mentor's intentions to appoint you as a postdoctoral scholar.

Indigenous applicants: Western has an Indigenous Affirmation Policy, you may be asked to affirm your Indigenous citizenship or membership. For details, please visit: https://indigenous.uwo.ca/initiatives/policiesguidelines/indigenous_affirmation.html

Appointment Details

Appointment Type

Proposed Start Date

Personal Details

First/Given Name

Middle Name

Last Name/Surname

Email Address

Phone Number

Birthdate

Student ID (if applicable)

Social Insurance Number

Gender

Current Address

Country

Address

City

Province/State

Postal/Zip code

Supervisor

First/Given Name

Last Name/Surname

Email (Directory)

Citizenship

Citizenship Country

Citizenship Status in Canada

Country of birth

Note: If you do not have a work permit yet, you do not need to fill in the following 3 fields.

Work Permit Authorization Number

Work Permit Authorization Start Date

Work Permit Authorization End Date

Degree

Country

University

State/Province

Degree Type

Major

Date of degree completion

Previous Western Experience

Are you a former student or employee of Western?

Western Employee ID Number (if applicable)

Western Student Number (if applicable)

Previous Postdoctoral Experience

Number of postdoctoral positions held (outside of Western)

Total months of postdoctoral training

Supporting Documents

The Applicant must submit a complete online appointment form with the following required attachments:

Canadian Common CV - No more than 10 pages
Proof of PhD - Copy of the diploma or official letter of completion that should indicate date Ph.D. degree was/will be granted
Letters of support from three referees - Maximum 2 pages
Funding Letter - Proof of funding from external granting agencies

Curriculum Vitae *

PhD Proof *

Reference #1 **

Reference #2 **

Reference #3 **

Funding Letter ***

*	Document required in order to submit your appointment form
**	References may be submitted directly from your referee to your supervisor
***	Only for Fellows

Human Check

Please type the word above

Upon completing the form, your potential supervisor will be alerted to this proposed appointment via email and be prompted to confirm additional details (duration, salary etc.) An email will be directed to you upon your supervisorï¿½s authorization summarizing the details of your appointment and requesting your confirmation.

Terms and conditions

I have read the New Postdoctoral Scholar Checklist and I am aware of the rights and responsibilities of a new Postdoctoral Scholar at The University of Western Ontario

I certify that the information submitted within this application are true, complete and correct including my declarations as to citizenship status in Canada, and that all information relevant to a decision on the application has been disclosed. I understand that it is my responsibility to keep The University of Western Ontario informed of any relevant changes to my information occurring between the date of my initial submission and my appointment as a postdoctoral scholar.