Research Institute Membership Application Welcome to the application page for the Research Institute for Health Care Education. Thank you for your interest. To apply, you will need to complete the form below & submit the following documents: One page Letter of Interest describing your research interests/research program and how they align with the Vision, Mission and 1 Primary Theme of the RIHCE Up-to-date CV Letter of Support for your participation in the RIHCE from your supervisor (students and trainees) OR Dean or Chair or equivalent (faculty and researchers). If applicable, this letter should also outline your protected time for research. Personal InformationName* Mr.Mrs.MissMs.Dr.Prof.Rev. Prefix First Middle Last Email* Enter Email Confirm Email Phone*Are you a student or trainee*YesNoName of SupervisorDepartment / FacultyMichener Institute of Education at UHNUHN (University Health Network)University of TorontoHow you would like to be contacted?*DirectlyDirectly and via Administrative AssistantName of Admin*Name of Administrative AssistantAdmin Email* Email address for administrative supportAdmin PhonePhone number for administrative supportProfessional InformationPrimary Institution*Primary Department*DivisionPosition/Role*Primary Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanÅland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarrussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRéunionRomaniaRussiaRwandaSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUS Minor Outlying IslandsUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabwe Country Professional credentials(for example, MSc, RN, RRT)List 2-6 keywords for your research interestsKeyword 1*Keyword 2*Keyword 3Keyword 4Keyword 5Keyword 6Research InstituteTheme affiliation*- Select a Primary ThemeSocieties, Systems and StructuresTeaching, Learning and PracticeTechnology, Innovation and SimulationSelect the Theme that best fits your research interestsDo you have protected time for research?*YesNoWhat percent %*Required DocumentsSubmit a one-page letter of interest describing your research interests/research program and how they align with the Vision, Mission and 1 Primary Theme of the RIHCE.Letter of interest*Accepted file types: doc, docx, pdf.Please submit your Letter of Interest using the file name format: LOI_lastname_firstnameCurrent CV*Accepted file types: doc, docx, pdf.Please submit your current CV using the file name format: CV_lastname_firstnameSubmit a letter of support for your participation in activities at the Research Institute for Health Care Education from your Supervisor (students and trainees) or Dean or Chair or equivalent (all faculty and researchers). This letter should also describe your protected time for research, if applicable.Letter of Support*Accepted file types: doc, docx, pdf.Please submit your Letter of Support using the file name format: LOS_lastname_firstnamePrincipal Investigator StatusWould you like to be considered for PI status*YesNoPlease read UHN PI Eligibility Criteria to assess if you are eligible to hold grants and administer funds through UHN before clicking yes.