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Fellowship
Distinguished Fellow
Research & Programs
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Home
About
Fellowship
Distinguished Fellow
Research & Programs
Contact

Canadian Academy for Research & STEM Advancement (CARSA)

Professional Fellow Application Form

For accomplished professionals and researchers who have demonstrated exceptional ability, advanced qualifications, and at least five years of impactful experience in research, STEM, and related disciplines.

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Personal Information

Full Name *

Email Address *

Phone Number

Date of Birth

Nationality

Current Country of Residence

LinkedIn / Professional Profile (optional)

Professional and Academic Background

Current Position / Title

Institution / Organization

Highest Degree Earned

Field of Specializa

Institution and Year of Graduation

Upload Academic Credentials (Degree / Diploma / Certificate)

Areas of Professional Expertise

Select or describe your primary area(s) of contribution in research, STEM, and related disciplines.

Engineering and Technology
Computer Science / Data Science / AI
Life Sciences / Health Sciences
Physical Sciences / Environmental Studies
Education and STEM Pedagogy
Innovation, Entrepreneurship, and Applied Research
Policy, Development, or Leadership in STEM fields
Multidisciplinary
Other (please specify)

Other

Summary of Professional Achievement

Briefly describe your most significant contributions or accomplishments in your field (200–300 words). Examples: technology development, policy initiatives, or recognized professional achievements.

Upload Supporting Evidence (Publications, Portfolio, Project Reports, etc.)

Recognition and Professional Impact

List any awards, honors, recognitions, or media features demonstrating the significance of your contributions.

Attach supporting documents (press features, certificates, testimonials)

Leadership, Mentorship, and Service

Describe your leadership, mentoring, or service to your profession, community, or field of research and innovation (150–200 words).

and Position Institution

Professional References

Provide at least two referees who can attest to your professional competence, leadership, and impact.

Supporting Documents Checklist

Detailed Curriculum Vitae (CV, max 3 pages)
Academic credentials (degree or transcripts)
Evidence of professional experience (employment letter, portfolio, or publications)
At least two recommendation letters from recognized professionals or supervisors
Proof of awards, recognitions, or media mentions (if available)

Declaration

I declare that the information provided herein is accurate and complete to the best of my knowledge.
I understand that false statements or misrepresentation may result in disqualification or revocation of fellowship.

Digital Signature

Date

Canadian Academy for Research & STEM Advancement (CARSA) Inc.

Registered in Ontario, Canada — Corporation No. 1001367523

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All Rights Reserved

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