Career Break Statement 

This is an optional form for applicants who wish to provide an accompanying statement to explain any career breaks or disruptions that have impacted their academic achievement as part of their graduate research degree and/or scholarship application. The form is to be uploaded in the Miscellaneous Document section of the on-line application form.

Applicant name:		Applicant Number:		

If you have experienced any career disruptions that have impacted your academic achievements, please provide a brief summary, including an explanation of the ways in which your career was impacted. 
Career disruptions may include, but are not limited to, periods of non-academic work; parental leave/caregiving responsibilities; major illness/injury/personal trauma/disability; natural disasters.