ANNEX 1

QES ADVANCED SCHOLARS (QES-AS)

CANADIAN UNIVERSITY ANNUAL REPORT

2017 – 2018

REPORT ON INDIVIDUAL SCHOLARS

Due: April 30, 2018

The annual report describes all activities undertaken by the University and its partners for the period ending March 31, 2018. Activities must clearly show how they contribute toward meeting Project objectives. Please complete a copy of this form (Annex 1) for every QES-AS funded scholar who began their scholarship between April 1, 2017 and March 31, 2018 and submit the complete report via email to qes-as@univcan.ca no later than April 30, 2018 along with the other components of the report. We encourage the use of bullets to lighten the presentation.

General information

Name of Canadian university:	--Click here and select your university from the dropdown menu--
Title of QES -AS project:

QES-AS Scholar

Please provide the following information for each QES-AS scholar who began their scholarship before March 31, 2018. Please save each document under the researchers name and submit along with all other annual report documents.

*Note: only include researchers who began their scholarship between April 1, 2017 and March 31, 2018.

QES-AS Scholar
First Name	Last Name
Gender (M/F)	Country of Citizenship
Name of Home Institution	Status at Home Institution
Scholarship Start Date (dd/mm/yyyy)	Scholarship End Date (dd/mm/yyyy)

Research Placement N.B. If the information on the Research Placement is not available at this time, you will be required to submit this in next year’s annual report.
Name of Research Placement Partner (must represent at least 30% of the total award time)
Name of main contact	City
Research placement start date (dd/mm/yyyy)	Research placement end date (dd/mm/yyyy)
Please provide specific information on the work done while at the research placement partner:

Leadership

Please describe 2 or more activities organised by your university which helped build the scholar`s leadership skills and describe the skills that were developed/enhanced/showcased. Please provide e-documents or web links related to activities if possible.

Activity	Date (dd/mm/yyyy)	Description of activity and skills developed/enhanced/showcased
1.
2.
3.
4.

Outputs

Please provide information on the following outputs. If applicable with e-documents or web links related to the activities if possible.

Conference Attended	Role in conference
1.	☐ Presenter	☐ Participant
2.	☐ Presenter	☐ Participant
3.	☐ Presenter	☐ Participant

Publications the scholar contributed to
1.
2.

Institutional Research Capacity Strengthening

As you know, the objective of the QES-AS funding is to strengthen the research capacity of the LMIC partner institution. Please provide the following information:

How will this researcher`s experience help strengthen the research capacity of the LMIC institution? Please be specific:

Please outline the knowledge transfer plan developed for this researcher, providing specific deliverables:

Name and title of the person at the LMIC partner institution who helped prepare and who signed off on the knowledge transfer/reintegration plan for this researcher:

Name	Title

Community Engagement

Community engagement activities are mandatory. Please provide details of all community engagement activities either organised by the university, by the partner institution or by the scholar themselves. If needed, please add additional rows.

Description of community engagement activity 1
Scholar’s role in the activity
Scholarly or leadership skills demonstrated or acquired through or by the activity
Date (dd/mm/yyyy)	Location

Description of community engagement activity 2
Scholar’s role in the activity
Scholarly or leadership skills demonstrated or acquired through or by the activity
Date (dd/mm/yyyy)	Location