Canadian Academy for Research & STEM Advancement (CARSA)

Distinguished Fellow Nomination / Application Form

The Distinguished Fellowship is the highest honor of the Canadian Academy for Research & STEM Advancement (CARSA).It recognizes individuals whose original contributions, leadership, and influence in research, STEM, and related disciplines have achieved national or global significance.

Candidate’s Information

Full Name

Email Address

Phone Number

LinkedIn Profile URL

Professional Website / Google Scholar / ORCID (optional)

Professional Profile

Current Position / Title

Institution / Organization

Highest Degree Earned

Evidence of Distinguished Contribution

A. Foundational or Transformative Research / Innovation

Describe your original contributions, discoveries, or innovations and their impact on your field, society, or industry (200–300 words).

Optional Media or Online Link (e.g., project site, Portfolio page, etc.)

Date Link etc.)

B. Publications and Scholarly Impact

List some representative works (peer-reviewed papers, patents, books, or equivalent outputs). Include citation data or other impact measures where available.

Upload Supporting Files

OR Provide Online Links (Google Scholar, ResearchGate, institutional page, etc.)

Recognition and Professional Influence

List major honors, awards, or recognitions that highlight your professional distinction — including invited talks, interviews, keynote addresses, citations, or media coverage (e.g., TV, podcasts, news features, YouTube presentations).

Upload Files (PDF/JPEG)

OR Provide Online Links (YouTube, media features, podcast, etc.)

Leadership and Service

Describe your leadership or advisory roles such as heading research teams, judging or reviewing peers’ work, mentoring, or serving on national/international committees (150–200 words).

Field #32 (copy)

Optional Link (e.g., conference site, judging announcement, professional board profile)

Candidate’s Supporting Documents

Upload professional headshot photo

Upload CV

Supporting Documents ⁠(Optional).

Declaration

I confirm that all information and materials provided are true and accurate.
I understand that nomination does not guarantee selection and that all decisions of the CARSA Fellowship Review Panel and Board of Director are final.
I consent to CARSA using my photo and professional information on its website and related media, in accordance with applicable data protection laws.

Digital Signature

Date