Research Assistant Database
The purpose of this form is to collect information for a database of students who are interested in being contacted when opportunities for Research Assistant positions arise. The completed form will be submitted to the Daphne Cockwell School of Nursing.

Please note that personal information is collected under the authority of the Freedom of Information and Protection of Privacy Act. We only collect information needed to operate our programs, such as your name, contact information, relationship to the university, and references. If you have any questions about the collection or use of this information, contact the Associate Director, SRC, at 416-979-5000, ext. 4557.

Name *
Your answer
Student number
Your answer
Phone number *
Your answer
Email address *
Your answer
If you are currently enrolled in a program, please specify: *
Program Start Date *
Month and Year (i.e. September 2012)
Your answer
Anticipated Graduation Date *
Month and Year (i.e. June 2013)
Your answer
Have you taken a research course? *
If yes, please describe:
Your answer
Research Experience *
Check all that apply, but please note: your research skills will develop as a result of RA work experience. Please do not be discouraged if none of these listed items apply to you.
Desired Research Experience *
Include research interests
Your answer
Availability *
Start and end dates, hours per week
Your answer
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