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7/28/2019 Masters Application Form 2014
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UNITED STATES-INDIA EDUCATIONAL FOUNDATION
Fulbright House, 12 Hailey Road, New Delhi 110 001
Preliminary Application Form
for2014-2015 Fulbright-Nehru Masters Fellowships
Application Instructions
Please read these instructions carefully:
All applications must be computer generated. Handwritten or typed applications will not be accepted.
Please do not exceed the word limit or attach additional pages to answer questions, unless otherwise
specified.
Applications should be submitted to USIEF as follows:
1. Submit your completed application to [email protected] along with your curriculum vitae orresume as attachments. Your CV should provide a complete picture of your educationalbackground, work experience and all major accomplishments (publications, awards, membershipsin associations etc.). It should not exceed 3 typed pages. Do not include any photographs.
Warning: Plagiarism in the application will lead to disqualification.
Your application along your CV should not exceed 4 MB. Please indicate your full name and grantcategory in the subject line of your email. For instance, if your name is Amit Sharma, you shouldwrite Amit Sharma Fulbright-Nehru Masters Application, in the subject line.
2. Print out the copy of your application and sign it. If you are not employed, please forward thesigned copy with the following enclosures to the USIEF office in your region. If you are employed,you should forward the signed copy of your application through proper channel with the followingenclosures to reach USIEF by the application deadline.
Self attested photocopies of mark sheets and diploma/degree certificates from bachelorsdegree onwards.
Self-attested photocopies of proof of your work/professional experience, if applicable
Photocopies of test score reports (TOEFL, GRE or GMAT), if applicable
Photocopies of writing samples, if any
Photocopies of correspondence with U.S. universities
If you have a deferred admission, please attach a scanned copy of the deferral letter from the
U.S. university
3. All applicants are advised to request three referees to send their recommendations on theprescribed Masters Confidential Letter of Reference forms to Executive Director, USIEF,
Fulbright House, 12 Hailey Road, New Delhi 110 001 no later than the applicationdeadline. These forms can be downloaded from the USIEF website.
Application Deadline: July 1, 2013
mailto:[email protected]:[email protected]7/28/2019 Masters Application Form 2014
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UNITED STATES-INDIA EDUCATIONAL FOUNDATION12 Hailey Road, New Delhi 110 001
Preliminary Application Form
for
2014-2015 Fulbright-Nehru Masters Fellowships
[Application must be computer generated]
1. Name: [Surname/Family Name] [First Name] [Middle Name]
2. Gender: Male Female Marital Status: Single Married
3. Date of Birth: [dd/mm/yy] Age: Place of Birth:
4. Country of Citizenship:
5. Designation, Name of the Organization and Address (if applicable):Phone: [Office] [Fax] [E-mail]
6. Academic Record:Please list educational institutions currently attending/have attended.
Name of
Degree/Diploma
Name and Address of Institution Major Subject Year
From To
Percentage
Senior Secondary Intermediate, HigherSecondary, 10 + 2etc. (specify) Bachelors (specifydegree and indicateduration) Masters(specify degree andindicate duration)
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Any otherprofessional ortechnical degree
7. a) Proposed Field of Study [Choose one]:
Arts and Culture Management including Heritage Conservation and Museum Studies
Environmental Science/Studies Higher Education Administration
Public Health
Urban and Regional Planning
Womens Studies//Gender Studies
b) Area of Specialization that you wish to pursue (Please refer to the Eligible Fields of Study descriptions in the
announcement)
8. Employment Record: List up to three paid/voluntary employments beginning with the latest. Describe the mission of
each office where you worked and describe each position you have held listing two most important roles/functions in
the JobProfile/Responsibilities. [Note: To be eligible, you must have at least three years full-time [paid or voluntary]
professional work experience in an area directly relevant to your chosen field of study.]
I) Name of Employer/Organization:
Mission of the Organization:
Your designation: Period of Employment: From: To:
Your Job Profile: [List two most important roles/functions]
1.
2.
II) Name of Employer/Organization:
Mission of the Organization:
Your designation: Period of Employment: From: To:
Your Job Profile: [List two most important roles/functions]
1.
2.
III) Name of Employer/Organization:
Mission of the Organization:
Your designation: Period of Employment: From: To:
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Your Job Profile: [List two most important roles/functions]
1.
2.
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9. Please list community service, sports or cultural activities in which you have participated regularly in the past five
years. If you were a team leader, council member or other officer in any institution or activity, please note that as well.
Type of activity Institution Duration of participation
From To
10. Please indicate any scholarships, awards, honors that you have received, with titles and dates.
11. List any books, articles or theses published by you especially in your proposed field of study.
12. Have you traveled, lived, or studied in any country other than your own? If yes, please indicate places, dates and
reasons.
13. The following questions are designed to provide us with more information about you. They are an important part of yourapplication. Do not exceed 20 lines of text forANY TWO of the following questions:
If you were given one year to spend in service on behalf of others, what would you choose to do, and why?
Indicate a person who has had a significant influence on you, and describe that influence.
Please describe incidents in your personal and professional life where you show your leadership. Give one
example each.
Imagine that it is the year 2020. What will you be doing, and where?
14. Statement of Purpose: Write a detailed essay which describes your future career plans, why you want and need tostudy
in the U.S. at the graduate level. Also explain how your study plan fits in with your previous academic/professionaltraining and future objectives. Describe how you will utilize the U.S. academic experience on your return to India. Yourstatement is an essential part of your application. Please use only the space provided. Your answer should not exceed50 lines of text:
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15. Personal Statement: This should be a narrative statement showing your strengths as a candidate for this fellowship.It
should include information about your education, practical experience, special interests and any significantfactors/accomplishments that have influenced your educational or professional development which distinguishes youfrom others and which you would like to bring to the attention of the Selection Committee. Please use only the spaceprovided. Your answer should not exceed 50 lines of text:
16. The purpose of the Fulbright Program is the promotion of mutual understanding among people from the U.S. and India.This involves more than academic/professional work. During your Fulbright grant, do you anticipate becominginvolved in any way with your host society beyond the scope of your immediate academic objectives? If yes, explainhow. If no, why not? Please use only the space provided. Your answer should not to exceed 15 lines of text.
17. University Preferences: It is not a requirement nor is it expected for you to identify U.S. institutions at which you
would like to study. However, if you do have preferences, please list in order of priority four schools of your choice.Indicate specific departments and/or programs. Provide specific reasons for each choice. If you have alreadysubmitted an application form directly to any university in the U.S. or are in contact with professors, please attachcopies of correspondence. Provide names, e-mails, and/or phone contacts for professors you are in touch with. Yourpreferences will be taken into consideration as far as possible.
If you have applied to an institution earlier and have received a deferral, please attach a copy of the deferral letter.Please note that should you be recommended for the Fulbright-Nehru Masters Fellowship, then USIEF will not applyto any other institution and will seek confirmation of placement only at the deferred institution.
Name of University Department Specialization/Concentration Specific Reasons Contacts/E-mails ofProfessors
18. Testing: If you have not taken the Test of English as a Foreign Language (TOEFL), Graduate Records Examination(GRE) or the Graduate Management Admission Test (GMAT) and are selected as a finalist, you will be required to
takethe TOEFL, GRE, TSE, or GMAT exams and submit the score reports to us and USIEF will cover the test fees. Ifyou have previously taken any of the above mentioned examinations, please give your score and date and place whereyou took the examination. Attach copy of your score report to the application if available.
Date(mm/yy)
Score Percent-ile
Date(mm/yy)
VerbalScore
Percentile
Quantitative Score
Percentile AnalyticalScore
TOEFL GRE
General
Exam
TSE GMATOther
GRESubjectExam
Date(mm/yy)
ScorePercentile
Subject Name
OtherTestName
19. Recommendations: List below names of three referees with their designation and contact details. Please request thereferees to complete a frank evaluation about you as an individual, and a scholar on the prescribed ConfidentialLetter ofReference Form and comment specifically on your study plans. The referee may be a supervisor at work, aprofessor/academic advisor/dean, or a community leader who is familiar with your academic and/or professional work.Please request your referees to send their letters of reference directly to the ExecutiveDirector, USIEF, 12 HaileyRoad, New Delhi 110 001, so as to reach by the application deadline.
1.
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2.
3.
20. Do you have a valid Passport? Yes No
If yes, please mention: Passport No. Date of Expiry:
21. Current Mailing Address:
Phone: [Res.] [Mobile] [E-mail]
22. Permanent Residence Address [specify if different from the Current Residence address]:
Phone: [Res.] 23. Indicate preferred mailing address [please tick any one]: Office Residence Permanent Home Address
24. Name, address and relationship of person to be contacted in India in case of emergency.
Phone: [Res.] [Mobile] [E-mail]
25. Employer's Comments [if employed]: Must be fi lled-in by the Administrative Head of the institution and not the
immediate supervisor. Your opinion about the usefulness of the program to the institution as well as to the applicant
on his/her return from the U.S. is invited. Please indicate whether the applicant, if selected, will receive leave for the
grant period.
Employer's Signature :
Official Seal: Name :
Date: Designation :
26. How did you learn about the Fulbright Program?(Please indicate all that apply)
Friend or relative University (specify) USIEF Website
Previous Fulbrighter Newspaper (specify) Internet Link
Poster/Flyer Other Publication (specify) Other (specify)
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Fulbright Presentation (specify)
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27. Please read carefully and sign:
I confirm that I have reviewed the general prerequisites for all Fulbright applicants and any specific guidelinespertaining to the Fulbright-Nehru Masters Fellowship.
I understand that any incomplete application, or application falsified by omission or misinformation will automatically
be disqualified.
I agree to inform USIEF about any overseas travel plans during the application cycle (July 2013 to June 2014).
I understand that initial selection in India does not guarantee me final placement and an award.
I also understand and agree that if a grant is awarded to me for study in the United States:
I will complete the prescribed course contemplated by the grant unless released as outlined for me by those
under whose supervision I will be placed.
I will abide by the policy guidelines established by the J. William Fulbright Foreign Scholarship Board in
connection with the grant.
_____________________________________
Date (dd/mm/yy) Name and Signature of the Applicant
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