Five-Weeks Study of the U.S. Institutes for Student Leaders on Women Leadership

November 28, 2012

Five-weeks Study of the U.S. Institutes for Student Leaders on Women Leadership

The Public Affairs Section (PAS) is soliciting nominations for a five-week Study of the U.S. Institute for Student Leaders on Women Leadership to participate in the program in the U.S. Students from Afghanistan, Egypt, India, Mongolia, Morocco, and Pakistan interested in the topic of Women's Leadership may be nominated to participate in this institute. Program dates are Saturday, June 22 to Saturday, July 27, 2013. The host institution will be announced at a later time. Applications and supporting documentation are due to PAS by 11:59 p.m. on December 22, 2012 via the mailbox.

A. Nominee’s Full Name, EXACTLY as it would appear on her passport.

First Name(s)

Middle Name(s)

Surname(s)

B. Gender (*only women may apply to this institute*)

C. Date of Birth (please spell out Month, Day, Year):

D. City of Birth:

E. Country of Birth:

F. Citizenship

-If you are a citizen of Afghanistan, do you have dual citizenship with another country? If so, which one?

G. Residency (City, Province, Country)

H. Candidate Contact Information

Phone:

Email:

Address:

I. Nominee’s Father’s Full Name and Contact Details:

First Name(s)

Middle Name(s)

Surname(s)

Phone:

Email (if applicable):

Address:

J. Medical, Physical, Dietary or other Personal Considerations: Please state if the candidate has any existing medical conditions or is currently taking any prescription medication. This will not affect candidate selection, but will enable the host institution to make any necessary accommodations.

K. Academic Major and Institution

L. Work and Volunteer Experience

M. Year in School and Expected Graduation Date:

(Students who are in their first semester of their first year or have completed their fourth/final year of undergraduate school are typically ineligible. Students in master's programs are ineligible.)

N. Extracurricular Activities, Memberships in Associations, Clubs, etc.

O. Previous Experience in the United States: Please list any and all trips the candidate has made to the United States and include approximate dates and the reason for travel.

P. Family Residing in the United States: Please list any immediate family members or fiancés who are currently residing in the United States, including city and state.

Q. Evidence of English Fluency(coursework, used in professional setting, etc.)

R. Justification statementby nominating officer: This is one of the most important components of the application. Why is this person well-suited for the program? Please fill out all information on the application form properly, except for section R, which should be completed by the US Embassy or an employee of the U.S. government. This can be submitted separately but should make sure that the program title “SUSI – Women’s Leadership” and the candidate name are on the justification and the subject heading of the email sent to .

S. Personal StatementPersonal Statement (no more than one page – to be completed by applicant) For the candidate: Please be as specific as possible. Tell us about yourself and your goals including the following: What about your background and/or interests that makes you competitive for this particular institute? 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.