Preliminary application forms for African Research Scholar and Fulbright Junior Staff Development Fellow can be obtained from here. Either click on the appropriate underlined link above or highlight, copy and print the selected form from below. Hubert Humphrey Fellowship application forms are available from the underlined link. 

FULBRIGHT AFRICAN RESEARCH SCHOLAR PROGRAM

PRELIMINARY APPLICATION FORM

Due: June 18, 2004

NOTE: This application form is intended for preliminary screening of candidates. Those who pass the preliminary screening will be asked to complete a more detailed formal application. The African Research Scholar Program is offered to African university Faculty to conduct research at a U.S. academic or research institution. Masters programs will be funded for 1 year, while Doctoral programs will be funded for 2 years.  Since doctoral programs usually are 4 years, candidates will have to look for their own resources for the other 2 years to complete their programs.

PERSONAL INFORMATION

Name :........................................................................................................................

Home Address:...........................................................................................................

Tel:............................... E-mail: ......................................... Fax: ..............................

Business Address: .................................................................................................….

Tel: ............................................. Fax:………………………………………………

Date and Place of Birth: …..........................................................……………………

 Country of Citizenship: ...……………………………………………………..........

EMPLOYMENT

Present Position: ........................................................................................................

Name, Position/Title and phone number or most direct method of contact of your immediate supervisor/dean/department head: .........................................................…

 .....................................................................................................................................
Other employment since your last degree:…………...................................................
......................................................................................................................................

Do you have your supervisor’s guarantee of employment upon return to Zambia? Yes ( ) No ( )

How long a period will your employer allow you to be absent for a study leave? ............................

Proposed major field of study and specific area of specialization: ................................................................................................................................................
................................................................................................................................................

Have you corresponded with any American Universities? If so, specify institution, field and date program would start:……........................................................................................

………………………………………………………………………………………………

EDUCATIONAL BACKGROUND

Degree you are seeking Master’s ( ) Ph.D. ( )

Highest degree presently held:................................………………………...................

Date degree granted:..........................………………....................................................

Field of study:.........................................................................………...........................

Name of Institution: ................................................…………….................................

Location of Institution:....................................………………......................................

Please attach the following documents to this application:

  1. A typewritten statement (of no more than 500 words) of your educational objectives. For Ph.D. candidates include a (3 –5 page) typed detailed project statement of your area of intended specialization/study.
  2. A list of all universities that you have attended (include dates).
  3. Official documentation attesting to your performance (Grades and certification of Diploma or degree) from the college or university from which you received your Bachelor’s (and if applicable, Master’s) degree
  4. Typed statement from your supervisor which attests to his/her support for this project and an evaluation of your qualifications.

*NOTE: This form and accompanying documentation must be returned to Public Affairs Section at the American Center, COMESA CENTER, Ben Bella Road by June 18, 2004. Send to:           

CULTURAL AFFAIRS ASSISTANT
PUBLIC AFFAIRS SECTION
P.O. BOX 32053
LUSAKA, 10101

PEASE NOTE THAT INCOMPLETE APPLICATIONS WILL NOT BE CONSIDERED.

 

FULBRIGHT JUNIOR STAFF DEVELOPMENT PROGRAM

PRELIMINARY APPLICATION FORM

Due: June 18, 2004

NOTE: This application form is intended for preliminary screening of candidates. Those who pass the preliminary screening will be asked to complete a more detailed formal application. The Junior Staff Development Program provides support for scholars pursuing masters or doctoral level degrees from U.S. Universities.  Masters programs will be funded for 1 year, while Doctoral programs will be funded for 2 years.  Since doctoral programs usually are 4 years, candidates will have to look for their own resources for the other 2 years to complete their programs.

PERSONAL INFORMATION

Name :........................................................................................................................

Home Address:...........................................................................................................

Tel:............................... E-mail: ......................................... Fax: ..............................

Business Address: .................................................................................................….

Tel: ............................................. Fax:………………………………………………

Date and Place of Birth: …..........................................................……………………

 Country of Citizenship: ...……………………………………………………..........

EMPLOYMENT

Present Position: ........................................................................................................

Name, Position/Title and phone number or most direct method of contact of your immediate supervisor/dean/department head: .........................................................…

 .....................................................................................................................................

Other employment since your last degree: …........................................................................
................................................................................................................................................

Do you have your supervisor’s guarantee of employment upon return to Zambia? Yes ( ) No ( )

How long a period will your employer allow you to be absent for a study leave? ............................

Proposed major field of study and specific area of specialization: .......................................
................................................................................................................................................

Have you corresponded with any American Universities? If so, specify institution, field and date program would start: ..............................................................................................

……………………………………………………………………………………………..

EDUCATIONAL BACKGROUND

Degree you are seeking Master’s ( ) Ph.D. ( )

Highest degree presently held:…..................................………………………...................

Date degree granted:….............................………………....................................................

Field of study:................................................................................………...........................

Name of Institution:.........................................................…………….................................

Location of Institution:...........................................………………......................................

Please attach the following documents to this application:

  1. A typewritten statement (of no more than 500 words) of your educational objectives. For Ph.D. candidates include a statement of your area of intended specialization/study.
  2. A list of all universities that you have attended (include dates).
  3. Official documentation attesting to your performance (Grades and certification of Diploma or degree) from the university from which you received your Bachelor’s (and if applicable, Master’s) degree
  4. Typed statement from your supervisor which attests to his/her support for this project and an evaluation of your qualifications.

*NOTE: This form and accompanying documentation must be returned to Public Affairs Section at the American Center, COMESA CENTER, Ben Bella Road by June 18, 2004. Send to:

CULTURAL AFFAIRS ASSISTANT
PUBLIC AFFAIRS SECTION
P.O. BOX 32053
LUSAKA

PEASE NOTE THAT INCOMPLETE APPLICATIONS WILL NOT BE CONSIDERED.