FULBRIGHT PROGRAM AFGHANISTAN
APPLICATION FORM FOR THE HUBERT H. HUMPHREY FELLOWSHIP PROGRAM
The Hubert H. Humphrey Fellowship Program brings accomplished mid-career professionals with demonstrated leadership potential to the United States for a year of graduate-level non-degree academic coursework and professional development activities. This ten month program consists of academic coursework and an internship in a relevant professional organization. By providing future leaders and policy makers with experience in U.S. society, culture, and professional fields, the program provides a basis for lasting, productive ties between Americans and their professional counterparts overseas. The Hubert H. Humphrey Fellowship Program provides ten months ofnon-degree academic study and related professional experiences in the United States. All grantees receive tuition, a monthly stipend, supplemental health and accident benefits, book and supplies allowance, travel support and the opportunity to attend Humphrey enrichment activities and seminars.
***READ THE CHECKLIST CAREFULLY BEFORE COMPLETING APPLICATION***Application Form / · Follow the instructions carefully and answer all questions completely.
· Each part of the application form must be completed in English. Incomplete applications will not be considered.
· Use the tab key to move from field to field; Do not exceed the space provided in text boxes.
Citizenship Requirement / · Must be Afghan citizens, currently residing in Afghanistan.
· Dual citizens or permanent residents of other countries are not eligible.
· Applicants with a pending immigrant visa application, including SIV, are not eligible.
· All Fulbright programs in Afghanistan provide support for the recipient ONLY. Dependents, including spouses (Maharam), cannot accompany the recipient.
Work Experience Requirement / · Applicants for the Hubert H. Humphrey Fellowship Program are the mid-career professionals with demonstrated leadership potential.
· Proof of at least five years’ relevant work experience must be included in the curriculum vitae
Personal Identity / · Applicant must enter his/her personal information accurately as it appears (or will appear) on his/her passport.
English Language Requirement / · A TOEFL iBT® score of 75 is a prerequisite when applying for the Hubert H. Humphrey Fellowship Program.
· The candidate must have a valid TOEFL iBT score and include a screenshot of their highest score in the application package.
· All nominated candidates who pass the interview process may be required to retake the TOEFL iBT. Those candidates who get the highest scores in the TOEFL iBT will be selected as finalists.
Personal Statement and Professional Objective Statement / · A narrative Personal Statement describing how you have achieved your current goals and a clearly articulated Professional Objective Statement are important components of your Application Form (Pages 8 and 9 of the Application)..
· Highlight your strengths and address any inconsistencies or perceived weaknesses.
Personal Development Plan / · A Personal Development Plan is the most important part of the Application Form (Pages 11-12 of the Application) and each question must be answered in detail.
Resume/CV / · An up-to-date curriculum vitae (CV) or resume is required and is part of the application package.
Letters of Recommendation / · Three (3) letters of recommendation from academic institutions and work supervisors are required.
· Letters of recommendation must NOT be written by applicant’s relatives or friends.
· All recommendation letters must be scanned and included in the application package.
Attested Diploma(s) and Transcripts Requirement / · Applicants must have a minimum of a four-year bachelor’s degree along with transcripts of 8 full semesters;
· All documents (diplomas and transcripts) must be attested by the Afghan Ministry of Higher Education (MoHE) and Ministry of Foreign Affairs (MoFA).
Translation of documents / · All documents, including diploma, transcripts, and recommendation letters, must be translated by an official translation company.
Not required / · A sample of English writing is not a pre requisite, but the applicants may attach a short research paper, published article, paper. Standardized tests, such as GRE and GMAT are not required.
Supplemental Materials
(Check when completed) / A complete application should include the following components
Completed Application Form Copy of attested Diploma and Transcripts Screenshot of TOEFL
Copy of three recommendation letters Updated CV Signed Application Instruction page
Submitting Complete Application / Applicants must print out this Checklist form, sign, scan and convert, with the completed Application Form and the rest of the Supplemental Materials, into one single PDF file. The PDF file name should include your full name and field of study.
The complete PDF file must be submitted via email to before the deadline (11:59pm Kabul time June 1, 2015). The subject line of your email must also include your full name and field of study.
Authorization of release of Information / Applicant Name:______Applicant Signature:______Date:______
THE HUBERT H. HUMPHREY FELLOWSHIP PROGRAM INFORMATION
PROGRAM DESCRIPTION: The Humphrey Fellowship Program provides mid-career professionals from designated countries of Africa, Asia, Latin America, the Caribbean, the Middle East, Europe and Eurasia with an opportunity to enhance their professional capabilities through participation in specialized, 10-month, non degree programs developed specifically for small clusters of Humphrey Fellows at selected U.S. universities. The Humphrey Program was initiated in 1978 to honor the memory and accomplishments of the late Senator and Vice President, Hubert H. Humphrey. Fellows are selected based on their potential for national leadership and commitment to public service, in either the public or private sector. The program provides a basis for establishing long-lasting productive partnerships and relationships between citizens of the United States and their professional counterparts in other countries, fostering an exchange of knowledge and mutual understanding throughout the world.
Funding for the Humphrey Program is provided by the U.S. government through the United States Department of State and other co-sponsors. The Institute of International Education (IIE) collaborates with the State Department's Bureau of Educational and Cultural Affairs in administering the program. The types of university programs arranged for Humphrey Fellows depart from a traditional discipline-oriented focus and have a problem-solving and experience-sharing emphasis. The programs are not degree-related or aimed at providing scholarly preparation or basic training in a field. The objective is to provide Humphrey Fellows with an overall experience that broadens their perspectives, enhances their capability to assume greater career responsibilities, and provides opportunities to establish useful professional contacts. To accomplish these objectives, programs are designed to include various combinations of course work, independent projects, internships, consultations with U.S. faculty or experts, field trips, and special seminars. Under the guidance of a designated faculty advisor or “coordinator,” Fellows plan programs that best suit their individual career development needs.
DURATION OF GRANT: The program arranged for Humphrey Fellows extends from August or early September to the following June. Applicants who need additional English training may be required to arrive in the United States as early as April for intensive language study before beginning their regular university program. Candidates must be able to participate in the full period of the English and/or university programs.
NONDEGREE STATUS: The program designed for Humphrey Fellows does not result in the awarding of a degree. While Fellows are able to enroll in courses relevant to their professional interests, the Humphrey Program is not appropriate for those who wish to concentrate on academic work required for a U.S. degree. Humphrey Fellows spend a considerable portion of their time engaged in off-campus activities such as internships, field trips, workshops, and special projects that give them practical experience in their professional fields. Fellows who successfully complete the program are awarded a Certificate of Participation.
FINANCIAL PROVISIONS: The Humphrey Fellowship provides a monthly maintenance allowance, a book and supplies allowance, tuition and fees when applicable, round-trip international travel to the host institution (and to the Fellow’s English-language training program when applicable) and domestic travel to Washington, D.C. for a special seminar. Supplementary funds are provided for professional activities such as field trips or attendance at conferences. Humphrey Fellowships are not renewable.
Humphrey Fellows should plan to bring with them some personal funds to cover incidental expenses not covered in the grant. Humphrey Fellowships do not include funds for dependents (family members). Humphrey Fellows are responsible for providing travel, insurance, and financial support for any dependents accompanying them in the United States. Please note that English and orientation centers cannot accommodate dependents. Therefore, dependents should not arrive in the United States until the Fellows are settled in their academic year programs and have secured housing (at least 30 days after the Fellow’s arrival) at the host campus.
PROGRAM FIELDS: The programs arranged for Humphrey Fellows are related to one of the following fields: agricultural development/agricultural economics; communications/journalism; economic development/finance and banking; educational administration, planning and policy; HIV/AIDS policy and prevention; human resource management; law and human rights; natural resources and environmental management; public health policy and management; public policy analysis and public administration; substance abuse education, treatment and prevention; teaching of English as a foreign language; technology policy and management; trafficking in persons, policy and prevention; urban and regional planning. The university programs do not address themselves to the scientific or technical aspects of these fields, but rather to broad policy-making and problem-solving issues.
PLACEMENT IN UNIVERSITY PROGRAMS: Candidates who are selected for fellowships are placed in clusters by field of interest at U.S. universities specially designated to host a group of Humphrey Fellows. IIE, therefore, is not able to make placements at specific universities requested by candidates, or to award fellowships enabling candidates to attend a U.S. university on the basis that they have already been admitted. Candidates should not apply directly to U.S. institutions.
APPLICATION FOR ADMISSION TO THE
HUBERT H. HUMPHREY FELLOWSHIP PROGRAM- 2016-2017
FOR MID-CAREER PROFESSIONAL DEVELOPMENT IN THE UNITED STATES
(Please read instructions carefully. All sections should be completed in English and be typewritten.)
1. PERSONAL INFORMATION:
Mr. Ms.
Gender: Male Female
Last Name:
First Name:
Date of Birth*: (Month-Day-Year) : *This should match the date listed on your passport
Birthplace: (City)
Country of Birth:
National Identification Number/Tazkira:
Marital Status:
DO YOU NOW HAVE, OR HAVE YOU EVER HELD: U.S. CITIZENSHIP? Yes No
DUAL CITIZENSHIP? Yes No
U.S. PERMANENT RESIDENCY? Yes No
2. PERMANENT MAILING ADDRESS:
Street:
City:
Province:
Country:
Telephone:
Work Phone:
Mobile Phone:
E-mail:
3. EMERGENCY CONTACT IN AFGHANISTAN:
NAME, ADDRESS, EMAIL AND TELEPHONE NUMBER OF INDIVIDUALS TO BE NOTIFIED IN CASE OF AN EMERGENCY:
Name:
Phone:
E-mail:
Relation to you:
4. INFORMATION FAMILY/CONNECTIONS IN UNITED STATES:
Please provide Name, Address, E-mail and Telephone number of individual contacts, relatives, or family members in the United States, if any
5. EDUCATIONAL BACKGROUNDList 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) / MAJOR FIELD OF STUDY / DATES
(Month and Year)
From To / ACTUAL NAME OF DEGREE OR DIPLOMA
(Do not translate) / DATE RECEIVED OR EXPECTED
6. Identify your current position or occupation.
Write the position title which best describes the activity in which you are currently involved.
7. OCCUPATIONAL EXPERIENCE:
(List 5 years work experience, beginning with the most recent employment)
NAME AND ADDRESS OF EMPLOYER / TITLE/TYPE OF WORK / DATES (Month and year)
From To
8. 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).
9. Fellowships and honors
10. Publications and Research
11. LIST SCHOLARSHIPS OR FELLOWSHIPS HELD AT PRESENT OR IN THE PAST (Give source or sponsor, amount, where held, and duration.)
12. INDICATE ANY ACADEMIC HONORS OR PRIZES WHICH YOU HAVE RECEIVED, WITH TITLES AND DATES
13. LIST ANY BOOKS, ARTICLES OR THESES PUBLISHED BY YOU, ESPECIALLY IN YOUR PROPOSED FIELD OF STUDY (Give title, place and date of publication)
14. 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.)
15. Research: (Including any research you have completed or in which you are currently involved.)
16. Publications:
17. TEACHING EXPERIENCE: (Including any teaching positions you have held or currently hold.)
18. KNOWLEDGE OF LANGUAGES: (Rate yourself Excellent, Good or Fair Include all languages in which you have some competence.)
Mother TongueLANGUAGE / READING / WRITING / SPEAKING
English
19. HOW MANY YEARS HAVE YOU STUDIED ENGLISH?
20. TOEFL IBT RESULTS (examination date and test score)
21. Please indicate countries outside your own, including the United States, in which you have lived, traveled, or studied. Please list dates (months/years) and reasons for each visit.
Reason for visit / Country visited / Dates of visitFrom (mo/yr) To ((mo/yr)
1.
2.
3.
4.
5.
6.
22. 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.)
23. 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.)
24. PERSONAL FINANCIAL INFORMATION
A. Your annual salary / (USD)Income per year from other sources: / (USD)
B. Will your salary be continued during your stay in the U.S.? / Yes / No
If yes what percentage? / %
C. List the relationships and ages of any persons who will require financial assistance from you during your academic year in the U.S.:
I.
II.
III.
IV.
25. RECOMMENDERS: List the names of persons from whom you have requested three recommendation letters.