Fulbright Masters and PHD Program Grants: Application For Study in The United States
Fulbright Masters and PHD Program Grants: Application For Study in The United States
Fulbright Masters and PHD Program Grants: Application For Study in The United States
INSTRUCTIONS Please fill out the application form according to the following instructions. YOU SHOULD NOT MAIL THIS FORM DIRECTLY TO ANY UNIVERSITY IN THE UNITED STATES. 1. 2. 3. 4. All forms in this application are to be completed in English and typewritten in black ink or printed from a computer (Font = Times Roman, Size = 11). Each page of the following application carries its own instructions that should be read carefully before proceeding. Questions must be answered completely and carefully. Please make every effort to limit your responses to the space provided. Completed applications should be returned to Fulbright Program Office in your country of citizenship as soon as possible. Before you begin this application, you should make sure that you are aware of all deadline dates and requirements as these may vary from country to country. Incomplete applications will not be considered. Do not mention the names of any U.S. universities you wish to attend in this application. The University Preference Sheet is included for that purpose. If you do not hold a valid Pakistani passport, apply for one immediately. Attach a copy of your complete CV. All successful candidates are required to sign a contract with USEFP that binds them to return to Pakistan immediately after their program in the U.S. and serve the country for the number of years equivalent to the length of their scholarship program minimum of two years. This contract is redeemable on a year-for-year basis (minimum of two years) after returning to work in Pakistan, so that as long as a person fulfills the service requirement, he or she will pay nothing. Otherwise, a grantee will be legally liable for the cost of his or her scholarship program in the U.S. on a yearfor-year basis. Additionally, successful candidates awarded Fulbright PhD grants are required to post a bond with the HEC. The bond is redeemable on a year-for-year basis. No grantee will be required to pay anything as long as they fulfill their contractual/ bond obligation. USEFP endeavors to place students in the university and program that best matches a students interests and achievements and offers cost sharing. Make arrangements to take GRE.
5. 6. 7. 8. 9.
10. 11.
they are not, an original English translation must be provided. Your recommenders have two ways in which they can submit their letters. You can print out the Letter of Reference form and forward to your recommenders who will then complete the forms and mail to USEFP. Your recommenders can complete the forms online and submit electronically. You must click on the Recommendation button on the Home page of the electronic application to register your recommenders. b. GRE score report: Valid GRE score report is required. You must indicate the USEFP registration code 9388 on the form when you take the exam.
b. Standardized tests: You will be required to take the following standardized tests. For instructions on registration, contact USEFP or the website for the test. GRE (Graduate Records Examination): The GRE is required by U.S. graduate schools and/or departments for candidates in most fields other than Business Administration and Law. USEFP requires the GRE even for applicants in business and law. You should make every effort to register for the earliest possible administration of the GRE. TOEFL (Test of English as a Foreign Language): TOEFL is an admissions requirement at U.S. institutions for applicants whose native language is not English. All shortlisted applicants will be required to take the TOEFL within two weeks of being notified. c. Optional tests, depending on your academic subject GRE SUBJECT TESTS are required in certain fields. If you are selected for the Fulbright Scholarship in this field, you will be asked to take the GRE Subject Test at a later date. It is not requirement for this Fulbright application. GMAT (Graduate Management Admissions Test): GMAT is an admissions requirement for applicants proposing to study Business or Management, as well as any fields which may fall within the scope of offerings of a Business school or department. If you are selected for the Fulbright Scholarship in this field, you may be asked to take the GMAT at a later date. It is not requirement for this Fulbright application. IMPORTANT Note carefully, you MUST indicate that you want your score reports sent to the United States Educational Foundation in Pakistan (USEFP). You must indicate the USEFP code 9388 on the registration forms and/or the forms provided at the time you take the exam.
GRE and GMAT scores are valid for five years. TOEFL scores are valid for two years.
OTHER IMPORTANT INFORMATION Change of Plans: You should inform USEFP promptly of any change in your academic status or future plans after your application has been submitted. Please e-mail us at [email protected]
NAME:
Last
First
Middle
Previous Name
PERMANENT ADDRESS:
MOST RECENT POSITION/STATUS: MOST RECENT AFFILIATION: ACADEMIC DEGREES Degree FELLOWSHIPS AND HONORS
Since Since
Major
Date Received
Institution
Country
DEGREE OBJECTIVE:
Bachelors
Master's
Doctorate
Non-degree
PROPOSED FIELD OF STUDY AND DESCRIPTION OF YOUR STUDY OBJECTIVES (Do Not Attach Additional Sheet)
2. NAME ON PREVIOUS ACADEMIC RECORDS: (If different from above) Do not complete shaded area. For IIE use only. 3. CURRENT MAILING ADDRESS: Institute of International Education C/O 809 United Nations Plaza New York, NY 10017-3580 Tel: 212 984Valid Until Fax: 212 984-5395 E-mail: @iie.org
6. GENDER:
Male
Female
10 DO YOU NOW HAVE, OR HAVE YOU EVER HELD: U.S. CITIZENSHIP? DUAL CITIZENSHIP? U.S. PERMANENT RESIDENCY? Yes Yes Yes No No No
8. COUNTRY OF CITIZENSHIP
9. COUNTRY OF RESIDENCE:
STUDY PLANS
11. DEGREE OBJECTIVE: Bachelors Masters Doctorate Non-Degree Visiting Student Researcher
12. WHAT IS YOUR PROPOSED MAJOR FIELD OF STUDY? BRIEFLY DESCRIBE THE SPECIFIC AREA OF YOUR FIELD IN WHICH YOU PLAN TO SPECIALIZE?
13. FUTURE PLANS: (Describe the career you plan to pursue after completion of study or research in the U.S. (e.g., teaching, government, business, industry or any plans you might have for continued study or research in your home country). Also indicate if you will be returning to former employment, or if you have been promised a position in your home country after completing your U.S. training).
Application Page 1
EDUCATION
14. LIST EDUCATIONAL INSTITUTIONS ATTENDED IN REVERSE CHRONOLOGICAL ORDER, INCLUDING ANY IN WHICH YOU MAY BE PRESENTLY ENROLLED: INSTITUTION AND LOCATION (List in reverse order and write name in full)
15. LIST SCHOLARSHIPS OR FELLOWSHIPS HELD AT PRESENT OR IN THE PAST (Give source or sponsor, amount, where held, and duration.)
16. INDICATE ANY ACADEMIC HONORS OR PRIZES WHICH YOU HAVE RECEIVED, WITH TITLES AND DATES
17. LIST ANY BOOKS, ARTICLES OR THESES PUBLISHED BY YOU, ESPECIALLY IN YOUR PROPOSED FIELD OF STUDY (Give title, place and date of publication)
18. LIST PROFESSIONAL SOCIETIES, FRATERNITIES OR OTHER ORGANIZATIONS IN WHICH YOU NOW HOLD MEMBERSHIP OR IN WHICH YOU HAVE BEEN ACTIVE IN THE PAST (Indicate if you have held an elective office.)
19. TEACHING EXPERIENCE: (Including any teaching positions you have held or currently hold.)
20. RESEARCH: (Including any research you have completed or in which you are currently involved.)
Application Page 2
21. IDENTIFY YOUR CURRENT POSITION OR OCCUPATION. (Write the Position title which best describes the activity in which you are currently involved.) 22. OCCUPATIONAL EXPERIENCE: (List positions held, beginning with the most recent employment, if any.) NAME AND ADDRESS OF EMPLOYER TITLE/TYPE OF WORK DATES (Month and year) From To
23. KNOWLEDGE OF LANGUAGES: (Rate yourself Excellent, Good or Fair. Include all languages in which you have some competence.) Mother Tongue READING WRITING SPEAKING
LANGUAGE English
EXAMINATION RESULTS
25. EXAMINATION DATES AND TEST SCORES: (Date if taken or future date for taking exams (Month/Year))
Date
Score
Percentile
Verbal Score
Quantitative Score
Analytical Score
Score
Subject Name
26IF YOU HAVE TRAVELLED, LIVED, OR STUDIED IN ANY COUNTRY OTHER THAN YOUR OWN FOR MORE THAN A MONTH, INDICATE PLACES, DATES AND REASONS, (Education, research, business, vacation, etc.)
27 EMERGENCY CONTACT: NAME, ADDRESS AND TELEPHONE NUMBER OF INDIVIDUALS TO BE NOTIFIED IN CASE OF AN EMERGENCY: IN YOUR HOME COUNTRY IN THE UNITED STATES
Application Page 3
NAME:
28.
COUNTRY:
Application Page 4
NAME:
29.
COUNTRY:
PERSONAL STATEMENT
This personal statement should be a narrative statement describing how you have achieved your current goals. It should not be a mere listing of facts. It should include information about your education, practical experience, special interests, and career plans. Describe any significant factors that have influenced your educational or professional development. Comment on the number of years of practical experience already completed in the field in which academic work will be done in the U.S. Do not mention specific U.S. universities at which you would like to study. NOTE: Please limit your response to the size of this text box of fifty lines of text.
Application Page 5
NAME:
30.
COUNTRY:
ADDITIONAL INFORMATION
Please refer to the instructions from your Fulbright Program Office. It is possible that the Fulbright Program Office in your home country will have specific information that it would like you to include on this page. If the Program Office does not have specific requirements, then in this section you may want to attach a professional resume (usually required for professional degrees such as law and MBAs) or a complete curriculum vitae (sometimes required for students pursuing theoretical academic fields). NOTE: Please limit your response to the size of this text box of fifty lines of text.
Application Page 6
NAME:
COUNTRY:
PERSONAL INFORMATION
STREET: CITY:
STATE/PROVINCE:
COUNTRY:
FAX:
WORK PHONE:
35. PLEASE DESCRIBE ANY PHYSICAL IMPAIRMENT YOU MAY HAVE. (This information is gathered for statistical purposes and to ensure appropriate placement. The Fulbright Program does not discriminate on the basis of race, color, religion, sex, national origin, and/or physical impairment.)
36. OTHER SCHOLARSHIPS: Indicate if you are planning to apply for a fellowship, scholarship, assistantship or other educational grant or loan from another organization, government or educational institution. (This information will not prejudice your application.)
37. REFERENCES: List the names of persons from whom you have requested letters of reference. NAME I. II. III. POSITION ADDRESS
40. HOW DID YOU LEARN OF THIS FULBRIGHT COMPETITION? (Please indicate all that apply.) Friend or relative Previous Fulbrighter Poster/Flyer University (Specify) Newspaper (Specify) Other Publication (Specify) Fulbright Website Internet Link Other (Specify)
Application Page 7
NAME OF APPLICANT:
COUNTRY:
PERSONAL FINANCIAL INFORMATION FORM Because some scholarships provide only for part of the cost of an academic year in the United States, it is necessary to know what portion of the total expenses you and your family can pay from personal funds.
INDICATE ALL FUNDS IN U.S. CURRENCY 41.
FUNDS AVAILABLE FOR YOUR FIRST YEAR OF STUDY IN THE UNITED STATES (U.S. Dollars)
(a) Family Funds 1. 2. b) Mothers occupation: Fathers occupation: What is the total amount your family can provide for your FIRST YEAR of study in the U.S.? Spouses occupation: $
What is the total amount you can provide from your own funds for your FIRST YEAR of study in the U.S.?
(c) in your home country in the U.S. or from any other sources? Yes If so, identify the source and indicate the estimated amount?
Source Estimated Amount
Other Funds Have you been awarded or do you expect to receive financial assistance from a university or institution No $ $ Subtotal of C GRAND TOTAL OF A, B, and C $
42.
$ $ $
FUNDS AVAILABLE AFTER YOUR FIRST YEAR OF STUDY IN THE UNITED STATES (a) If you remain for more than a year would the same amount of money as indicated in GRAND TOTAL above be available for your SECOND YEAR of study in the U.S.? (b) If No please specify the amount that will be available to you the SECOND YEAR: 1. 2. 3. Family Funds: Your Own Funds: Other Funds:
Yes
No $ $ $ $ Yes $ No
TOTAL of 1, 2 and 3
43. TRAVEL FUNDS (Do not include funds specified in Sections 41 and 42 above) (a) Can you pay for your round-trip travel to the U.S. if necessary? (b) Specify the amount you have available for round-trip travel:
44.
DEPENDENTS The Foreign Fulbright Student Program does not provide for dependents. THE FULBRIGHT PROGRAM CANNOT BE RESPONSIBLE IN ANY WAY FOR DEPENDENTS ACCOMPANYING YOU TO THE U.S. Should dependents accompany you, you will be responsible for providing travel, adequate insurance, and support for them. (a) List the relationships and ages of any persons who will require financial assistance from you during your stay in the U.S.:
(b)
Will these dependents accompany you to the U.S.? If Yes, state how you intend to provide for them during your year of study in the U.S.:
Yes
No
Application Page 8
NAME:
COUNTRY:
UNIVERSITY PREFERENCES
It is not a requirement nor is it expected for you to identify U.S. institutions at which you would like to study. However, if you do have preferences, please list in priority order three schools of your choice. Indicate specific departments and/or programs. Give specific reasons for each choice. If you have been in contact with professors, please provide names, email, and/or phone contacts for each one. Your preferences will be taken into consideration insofar as possible.
UNIVERSITY 1.
DEPARTMENT
DEGREE
SPECIALIZATION/ CONCENTRATION
2.
3.
46. OTHER INSTITUTIONS IN WHICH YOU MAY BE INTERESTED Please list any other U.S. institutions and departments in which you also may be interested. Feel free to share other information that you think might be helpful, e.g. preference for a geographic location, climate, etc.
47. It is not expected that you will apply for admission by direct application or correspondence with a university in the United States. If, however, you have already submitted an application form directly to any universities in the U.S., list the names of these institutions below and indicate the response you have received, if any. Please attach letters of admission, letters of invitation, and deferral requests to your application.
University/Department
Date of Application
Response to Application
Application Page 9
Mr. Ms.
(FAMILY NAME) 5. PERMANENT ADDRESS
(FIRST)
(MIDDLE)
(STREET)
(CITY)
(PROVIDENCE/STATE)
(COUNTRY)
(TELEPHONE)
7. INSTITUTIONS ATTENDED
DATES ATTENDED
Do not write below this line. For office use only DEGREE OBJECTIVE
STUDENT ID PRIORITY# PROGRAM #DESIGNATION TAX CODE PERSONAL FUNDS CASH TRAVEL
FIELD
DEGREE
PROG. ADMIN.
PLACEMENT ADMIN.
SPECIALIZATION
SUBMISSIONS SEND BY
CODE
INSTITUTION
DEPARTMENT/DIVISION
MAJOR DEGREE
SENT
RESULT
PLACEMENT INSTITUTION
INSTITUTIONS REQUESTED UNIVERSITY DEPARTMENT __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ UNIVERSITY DEPARTMENT __________________________________________________________________ __________________________________________________________________ __________________________________________________________________
IIE NOTES
ENGLISH TRAINING ASSIGNMENT: TOEFL ________/________ TSE TWE o YES o NO DATE AVAILABLE: REP DATE: GRE ________/________ GMAT ________/________ OTHER ________/______ __ EVALUATION & COMMENTS ________/______ MISSING DOCUMENTS:
________/_______
OTHER
FILE TO RO
Biographic Information Sheet Firs Name: Date of Birth (e.g. February 10, 2012): Postal Address: Permanent Address: Permanent City:
Last Name:
Province:
Phone #:
Mobil #:
Email ID:
Academic Information Proposed Field of Study: Current Enrollment: Start Date: (mm/yyyy) End Date: (mm/yyyy)
Current Institution:
Last Enrollment: Last Field of Study: Last Degree CGPA/ %age: Work Information
Current Position:
NAME:
Current Employer:
COUNTRY:
SIGNATURE FORM
Test Date: (mm/dd/yyyy) Official Report Attached: (Yes/No)
Test Date:
Note: Every information on this sheet is important, this sheet will not be accepted if CGPA of Foreign Degree & CGPA of Home Degree, (whether enrolled or finished) is not mentioned. INSTRUCTIONS: You must sign and date this form and forward it to the Fulbright Program Office in your home country.
By my signature, I authorize the Fulbright Program Office or its administrative agency: 1) to receive, and/or to request my TOEFL, TSE, TWE, GRE, SAT, Achievement Test scores or any other test score reports; 2) to send any of the above score reports to U.S. institutions on my behalf; 3) to apply on my behalf to U.S. institutions; 4) to request and receive information on the status of my application, including financial aid, from U.S. institutions; and, 5) to accept and decline offers of admission and financial aid on my behalf. AND I certify that the information given in this application is complete and accurate to the best of my knowledge. I understand that I am not entitled to hold, nor do I hold, U.S. citizenship or permanent residence. I understand that formal award of a grant is dependent upon my acceptance to a U.S. institution for study and my eligibility for a visa to the United States. Upon the completion of an authorized stay in the United States under the Fulbright Student Program, I agree to return to my home country for two (2) years to fulfill my home residency requirement. Signature Date (Month/Day/Year)
Signature Form
HOW LONG HAVE YOU KNOWN THE APPLICANT? IN WHAT CAPACITY HAVE YOU KNOWN THE APPLICANT? Teacher or Professor _______________________ 3. Employer or Job Supervisor Research Adviser Other (Please specify)
IN THIS RATING CHART, PLEASE EVALUATE THE APPLICANT IN COMPARISON WITH OTHER STUDENTS WHOM YOU HAVE KNOWN DURING YOUR PROFESSIONAL CAREER.
Excellent Intellectual Ability Knowledge of Field Work Habits Motivation to Pursue Graduate Study Seriousness of Purpose Potential For Significant Future Contribution in Field Resourcefulness and Initiative Emotional Maturity Adaptability to New Situations Leadership Qualities Teaching Potential
Very Good
Average
Below Average
NAME OF APPLICANT:
COUNTRY:
4.
PLEASE PROVIDE A CANDID EVALUATION OF THE APPLICANTS PAST PERFORMANCE AND ABILITY TO PURSUE AND SUCCESSFULLY COMPLETE A PROGRAM OF STUDY IN THE PROPOSED FIELD. YOUR INFORMATION WILL BE GIVEN CONSIDERABLE IMPORTANCE IN REVIEWING THIS APPLICATION.
SIGNATURE: ______________________________________________________________________________
DATE: ________________________________
PLEASE RETURN THIS COMPLETED FORM TO: U.S. EDUCATIONAL FOUNDATION IN PAKISTAN, P.O. BOX NO. 1128, ISLAMABAD, PAKISTAN, BY MAY 16, 2012. NOTE: IIE cannot guarantee this letter's confidentiality once it becomes part of a university's records.
1. 2.
HOW LONG HAVE YOU KNOWN THE APPLICANT? IN WHAT CAPACITY HAVE YOU KNOWN THE APPLICANT? Employer or Job Supervisor Research Adviser Other (Please specify)
3. IN THIS RATING CHART, PLEASE EVALUATE THE APPLICANT IN COMPARISON WITH OTHER STUDENTS WHOM YOU HAVE KNOWN DURING YOUR PROFESSIONAL CAREER.
Excellent Intellectual Ability Knowledge of Field Work Habits Motivation to Pursue Graduate Study Seriousness of Purpose Potential For Significant Future Contribution in Field Resourcefulness and Initiative Emotional Maturity Adaptability to New Situations Leadership Qualities Teaching Potential
Very Good
Average
Below Average
NAME OF APPLICANT:
COUNTRY:
4.
PLEASE PROVIDE A CANDID EVALUATION OF THE APPLICANTS PAST PERFORMANCE AND ABILITY TO PURSUE AND SUCCESSFULLY COMPLETE A PROGRAM OF STUDY IN THE PROPOSED FIELD. YOUR INFORMATION WILL BE GIVEN CONSIDERABLE IMPORTANCE IN REVIEWING THIS APPLICATION.
SIGNATURE: ______________________________________________________________________________
DATE: _______________________________
PLEASE RETURN THIS COMPLETED FORM TO: U.S. EDUCATIONAL FOUNDATION IN PAKISTAN, P.O. BOX NO. 1128, ISLAMABAD, PAKISTAN, BY MAY 16, 2012. NOTE: IIE cannot guarantee this letter's confidentiality once it becomes part of a university's records. Confidential Letter of Reference A Page 2
1. 2.
HOW LONG HAVE YOU KNOWN THE APPLICANT? IN WHAT CAPACITY HAVE YOU KNOWN THE APPLICANT? Employer or Job Supervisor Research Adviser Other (Please specify)
3. IN THIS RATING CHART, PLEASE EVALUATE THE APPLICANT IN COMPARISON WITH OTHER STUDENTS WHOM YOU HAVE KNOWN DURING YOUR PROFESSIONAL CAREER.
Excellent Intellectual Ability Knowledge of Field Work Habits Motivation to Pursue Graduate Study Seriousness of Purpose Potential For Significant Future Contribution in Field Resourcefulness and Initiative Emotional Maturity Adaptability to New Situations Leadership Qualities Teaching Potential
Very Good
Average
Below Average
NAME OF APPLICANT:
COUNTRY:
4.
PLEASE PROVIDE A CANDID EVALUATION OF THE APPLICANTS PAST PERFORMANCE AND ABILITY TO PURSUE AND SUCCESSFULLY COMPLETE A PROGRAM OF STUDY IN THE PROPOSED FIELD. YOUR INFORMATION WILL BE GIVEN CONSIDERABLE IMPORTANCE IN REVIEWING THIS APPLICATION.
SIGNATURE: ______________________________________________________________________________
DATE: _______________________________
PLEASE RETURN THIS COMPLETED FORM TO: U.S. EDUCATIONAL FOUNDATION IN PAKISTAN, P.O. BOX NO. 1128, ISLAMABAD, PAKISTAN, BY MAY 16, 2012. NOTE: IIE cannot guarantee this letter's confidentiality once it becomes part of a university's records. Confidential Letter of Reference A Page 2
Biographic information sheet Complete application form with signed signature page C.V Attested Transcript (from Matric or O-Level to onwards) copies of university transcripts should be attested by HEC Attested Degrees (copies of university degrees should be attested by HEC) Three Letter of references GRE