Spring 2020 Professional Fellows Program Application

Prefix

Surname

Personal Name

Gender

Date of Birth (MM/DD/YYYY)

Address Information

Current Residential Address

Current City

Current Country/Territory

Current Province

Current Postal Code

Contact Information

Mobile Number

Personal Email

Passport Information

Do you have a valid passport?

Passport Expiration Date (MM/DD/YYYY)

Place of Birth (as listed on your passport)

Have you been to the U.S. before?

If yes, when, for how long, and to do what?

Have you previously submitted an application for the Professional Fellows Program?

If yes, which month(s) and year(s) did you apply?

Professional Information

Name of Organization

Work Address

Work City

Work Province

Work Country/Territory

Work Postal Code

Work Phone

Work Email

Current Title

Number of Years in Current Position

Area of Focus

If other, please specify

Preferred Contact Information

Preferred Phone

Preferred Email

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Application Questions

1. Tell us why you would like to be considered for the fellowship and what you hope to learn from your placement with an NGO in the United States. (250 words or less)

2. In what ways might the lessons you learn from the program help in your professional development? (250 words or less)

3. Provide a brief description of the individual project you would implement after the fellowship and how it would benefit your work. This could be a research paper, a new program, or way of working at your organization, a series of lectures you deliver to organizations in you field in your home country/territory or something else. The detail, clarity, and feasibility of your project proposal is a critical component of your application. (250 words or less)

4. If your project described in question 3 could not be carried out, what is your fallback plan (a different proposal)? (250 words or less)

5. In what ways would this fellowship help you to develop and implement either individual projects? (250 words or less)

6. Please list three potential host organizations and explain in two or three sentences why they interest you. (Note: we do not guarantee that you would be placed at one of the organizations listed.)

How did you find out about the Professional Fellows Program?

If other, please specify

References: Please ask three (3) professional references to submit reference letters directly to the National Committee at pfp@ncuscr.org. In addition, please provide their information below.

1st Professional Reference

Name of Reference

Name of Organization

Job Title

Relationship to Applicant

Phone Number

Email

2nd Professional Reference

Name of Reference

Organization Name

Job Title

Relationship to Applicant

Phone Number

Email

3rd Professional Reference

Name of Reference

Name of Organization

Job Title

Relationship to Applicant

Phone Number

Email

Resume

Please upload a recent resume or CV. Files must be less than 2MB. Allowed file types: pdf, doc, docx.