Please describe any pre-existing medical conditions, including any prescription medication you may be taking, allergies, or other dietary or personal considerations.
This will not affect candidate selection, but will enable the host institution to make any necessary accommodations.
Main Field of study and career
Name and complete address of University or academic institute:
Name, address and years of high school.
Name, address and years of elementary school.
Please explain any gaps in your education / Have you ever been dismissed from a school or university? If yes, explain why.
Currently studying …… year of career
Expected graduation date: …………
Do you have a scholarship? If yes, please specify.
Please indicate any scholarships, academic awards or honors that you have received and the year received.
Active extra-academic or voluntary activities, independent of current professional responsibilities.
These should not include university committee work or other professional duties directly related to current employment
Please include: Position / Title / Organization
Are you an active member of any Association, Club or Group? Tell us about it!.
Please list all your previous trips to the United States and other countries and include approximate dates, reason for travel and if it was a scholarship, please specify.
From ……......….. to ….......….… Purpose………………………
Scholarhip= YES - NO (If yes, please specify)
Please list any immediate family members who are currently residing in the United States, including city and state.
Tell us about yourself and your goals. Please answer all the following questions:
What about your background and/or interests that makes you competitive for this particular institute (please be as specific as possible)?
What will you contribute to the group?
How do you expect this experience will affect your future academic and professional career?
How will it affect you personally?
Please structure your essay in paragraphs and limit your response to 250 words, single spaced.
Please discuss why you wish to participate in this program. Include how your participation in the Institute will enhance your work, improve education about the United States in your community, and help you achieve the "Other potential Outcomes" you have checked above.
IMPORTANT: Make sure your Video is available to the public or provide required access credentials (password & login info). If we cannot see the video, your application will not be considered.