Fellowships to Support an Enabling Legal Framework
for Civil Society in the Middle East/North Africa

Application Coversheet

1. Biographical Information

Prefix (select one from list):

Name:

Title:

Organization:

Mailing Address Line 1:

Mailing Address Line 2:

Country:

Postal Code:

Telephone Number:

Email Address:

Language / Writing Proficiency / Speaking Proficiency

2. Availability

The Fellowship is for 2-3 weeks between May and July 2013. Please indicate:

  1. Are you available for a 3-week fellowship? ___ Yes ____No
    If not, we assume you are available for a 2-week fellowship.
  2. Are there any time periods between months that you are unavailable to participate in this Fellowship?
  3. I am available during this entire period ____
  4. I available during his period with the exception of the following dates: ______

3. Assurances

Please initial next to each statement to indicate that you understand what will be asked of you:

I may incur fees while applying for a visa, but understand that I will be reimbursed.

My work will be subjected to USAID Branding and Marking requirements as contained in ICNL’s LEEP Branding Strategy and Marking Plan.

I understand that after the fellowship, I will be required to immediately return to my home country and remain there at least twelve months to help advance the legal framework for civil society.

4. ApplicationChecklist

Please note: your application will not be complete until all documents have been received. Incomplete applications will not be considered.

Please check here if you have previously applied for a fellowship. In this instance, you must resubmit only the application coversheet and a current resume/CV.

If this is your first time applying, please check that you have submitted the following:

Top of Form

1) Application coversheet.

2) Proposal (see Application Instructions for details).

3) Current resume or Curriculum Vitae -- This should not exceed five single-spaced pages.

Bottom of Form

5. Certification

Signature: ______Date:

By signing, you certify that you have carefully read the “Fellowship Application Instructions” and will comply with all program requirements should you receive the research fellowship.