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National Council for Eurasian and East European Research CARNEGIE RESEARCH FELLOWSHIP PROGRAM PROGRAMUL DE BURSE PENTRU CERCETTORI OPORTUNITI DE CERCETARE N STATELE UNITE ALE AMERICII N DOMENIILE TIINELOR UMANISTE I SOCIALE Programul este organizat de ctre Consiliul Naional de Cercetare a Eurasiei si Europei de Est (NCEEER) n cooperare cu Consiliile Americane pentru nvmnt Internaional: ACTR/ACCELS), i finanat de Corporaia Carnegie din New York, SUA. DESCRIEREA PROGRAMULUI: Consiliul Naional de Cercetare a Eurasiei si Europei de Est anun desfurarea ediiei 2013-2014 al Programului de Burse pentru Cercettori Carnegie. Programul, fiind finanat n ntregime de Corporaia Carnegie din New York, SUA, ofer savanilor din domeniul tiinelor umaniste i sociale din Republica Moldova, Armenia, Azerbaijan, Belarus, Georgia i Ucraina posibilitatea de a petrece un semestru academic (patru luni) n SUA pentru stagiuni de cercetare individuale FR obinerea gradului tiinific n instituiile americane de nvmnt superior i de cercetri tiinifice. Programul se petrece n baz de concurs i se adreseaz profesorilor universitari, doctoranzilor i cercettorilor din domeniul tiinelor sociale i umaniste din RM (antropologie, arheologie, istorie, relaii internaionale, politologie, jurnalism i stiine ale comunicrii, sociologie i asistena social, etnologie, culturologie, geografie, psihologie, administrare i gestionare, drept, criminologie, economie i business, lingvistic, limbi i literaturi strine, art, filosofie, pedagogie i administrarea procesului educaional, etc., inclusiv toate ariile interdisciplinare). Bursierii vor efectua cercetri tiinifice pe teme specifice din sfera tiinelor umaniste i sociale, la rentoarcearea n Moldova vor completa o tez (15-30 de pagini) i vor prezenta realizrile n cadrul prelegerilor i seminarelor cu scopul de a contribui la sporirea calitii nvmntului superior i a cercetrilor tiinifice n regiunea lor. Administrarea competiiei va fi asigurat de ctre Consiliul Naional de Cercetare a Eurasiei i Europei de Est (NCEEER) n colaborare cu Consiliile Americane pentru nvmnt Internaional: ACTR/ACCELS i Centrele de Resurse pentru Cercettorii din Caucaz (CRRC). Cheltuielile participrii la program sunt acoperite n ntregime i prevd: 1) Transportul tur-retur gratis de la domiciliul participantului pn la instituia gazd n SUA; 2) Participarea la programe de orientare local i n Seattle sau Washington D.C., SUA; 3) Bursa lunar; 4) Asigurarea medical i de via; 5) Accesul la fondurile bibliotecare i arhive, precum i organizarea activitilor la absolvirea programului. n plus, la solicitare sunt disponibile resurse adiionale pentru dezvoltarea profesional a participanilor prin procurarea crilor, echipamentului i a altor unelte de cercetare, sau prin susinerea deplasrilor la conferine tiinifice internaionale i achitarea taxelor de membru a formaiunilor profesionale n SUA. Bursele n cadrul acestui program vor fi oferite n baza resurselor disponibile ale Corporaiei Carnegie din New York. Termen limit de depunere a dosarelor de participare: 30 aprilie, 2013, 17:00 CRITERII DE ELIGIBILITATE: Pentru participare la program sunt invitai: Ceteni ai Republicii Moldova. Solicitani cu propuneri de cercetare care se ncadreaz integral, prin obiective i arie tematic, intr-un domeniu prioritar al Centrului de Studii Avansate i Educaie (CASE), Universitatea Umanist European din Vilnius Transformrile sociale din regiunea frontalier de vest a Eurasiei Moldova, Ucraina i Belarus (European Humanities University, Center for

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Advanced Studies and Education on Social Transformations in the Western Eurasia Border Region -- Belarus, Moldova, and Ukraine). Doctoranzi, cadre didactice universitare i cercettori la orice etap a vieii profesionale care n-au condus recent proiecte de cercetri tiinifice n instituiile americane. Posesorii titlului de doctor n tiine sau unui grad mai avansat, sau cei nscrii la doctorat la momentul aplicrii. Cu capaciti de exprimare oral i scris n limba englez care le vor permite s-i conduc cercetrile n mod independent i s comunice cu omologii si din SUA. Cu publicaii n domeniul profesional (doctoranzilor li se permite indicarea tezelor prezentate la conferine academice). Care nu vor avea impedimente la obinerea vizei SUA de tip J-1; Care pot participa la program n Statele Unite n septembrie 2013 (sau ianuarie 2014)

Programul ofer oportuniti egale tuturor solicitanilor i nu face discriminri pe baz de ras, culoare, sex, religie, origine naional sau etnic, handicapuri sau disabiliti. Nu sunt eligibili: Soii cetenilor SUA sau a altor ri strine. Persoane care au solicitat vize de emigrare n orice ar strin sau care au solicitat azil politic ntr-o ar strin (inclusiv posesorii sau solicitanii green card sau cei care au depus cereri la Programul de imigrare Diversity Visa). Angajaii Consiliului Naional de Cercetare a Eurasiei si Europei de Est, a Consiliilor Americane pentru nvmnt Internaional i Centrelor de Resurse pentru Cercettorii din Caucaz, precum i soii, copiii i nepoii acestora.

Programul de Burse Carnegie nu ofer suport financiar pentru copiii i membrii familiilor participanilor. Bursierii care au beneficiat de experiena oferit de programul Carnegie sunt obligai s se ntoarc n RM la data indicat. Dup expirarea acestui termen, aflarea participanilor n SUA este interzis i ei nu pot apela la autoritile consulare pentru obinerea vizei de emigrare sau lucru n SUA, timp de doi ani dup rentoarcerea n ar.

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CORPORAIA CARNEGIE DIN NEW YORK, SUA: Corporaia Carnegie din New York a fost creat de Andrew Carnegie n 1911 pentru a promova naintarea i difuzarea cunotinelor i nelegerii. Ca o fundaie ce acord granturi, organizaia depune efort s realizeze viziunile de filantropie a fondatorului s fac binele real i permanent n lumea aceasta. Domeniile prioritare ale activitilor Corporatiei au evoluat n timp, adaptndu-se circumstanelor schimbtoare. Direciile curente au fost create s corespund cu misiunea istoric a organizaiei. Curent, Corporatia acord granturi n domeniile educaiei, pcii i securitii internaionale, dezvoltrii internaionale i ntririi democraiei americane. ORGANIZAII CE ADMINISTREAZ PROGRAMUL: Consiliul Naional de Cercetare a Euroasiei i Europei de Est (NCEEER) Fondat n 1978, Consiliul Naional de Cercetare a Euroasiei i Europei de Est este un corp academic non-profit, a crui scop este de a ncuraja i susine cercetri de nalt calitate despre Europa de Est i CSI n domeniile sociale i umaniste. n decursul a 20 de ani, NCEER a acordat granturi i contracte de cercetare miilor de savani i instituii americane, lideri n cercetri academice a regiunii. Reeaua remarcabil a NCEER-ului n cadrul comunitii academice i a tiinelor sociale va spori oportunitile pentru savani i cercettori, vorbitori de limb rus, de a descoperi i angaja pe cei mai buni i strlucii colegi americani n disciplinele lor. Consiliile Americane pentru nvmnt Internaional: ACTR/ACCELS Fondat n 1974, Consiliile Americane pentru nvmnt Internaional: ACTR/ACCELS, este o asociaie privat profesional nonprofit care organizeaz schimburi educaionale dedicate cooperrii academice n spaiul CSI n ariile de cercetare, perfecionare a cadrelor didactice, dezvoltare a capacitilor lingvistice, precum i elaborare a materialelor i curriculumului. Programele Consiliilor Americane ofer studenilor i profesorilor americani i strini oportuniti de cercetri i studii aprofundate pe teritoriul fostei Uniuni Sovietice.

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CONDIII DE NSCRIERE: Solicitanii din Republica Moldova depun dosare de candidatur la adresa electronic apply@nceeer.org Alexey Kharlamov The American Councils for International Education: ACTR/ACCELS

str. Kogalniceanu 76 MD-2009 Chisinau, MOLDOVA Tel: (+37322) 225860 Fax: (+37322) 234873
E-mail: alexei@nceeer.org Website: http://www.nceeer.org/

ACTELE NECESARE 1. Formularul de participare, completat n limba englez, nsoit de o fotografie (4x5 cm). 2. Propunerea de cercetare (5-7 pagini, n limba englez), cu menionarea domeniului ales. 3. Curriculum vitae n limba englez, cu exprimarea evenimentelor n ordine de la cele mai recente. 4. Recomandrile de la dou autoriti tiinifice n domeniul general de specializare a candidatului sau n domeniile, la care se refer detaliat planul de realizare a cercetrilor. 5. Lista publicaiilor, realizrilor i proiectelor profesionale. 6. Acordul referitor la informaia privat, semnat. 7. Eventual, alte date, documente sau informaii care pot - n opinia candidatului - s ajute Comisiei de calificare n aprecierea adecvat a candidaturii acestuia. Candidaii sunt ncurajai s-i pstreze o copie adiional a documentelor depuse pentru arhiva proprie, lund n consideraie faptul c acestea nu vor fi rentoarse. Candidaii eligibili vor fi invitai la Kyiv pentru convorbiri personale cu Comisia de calificare multinaional n perioada mai iunie 2013. Semi-finalitii vor fi contactai prin telefon i/sau pot de reprezentanii NCEEER/Consiliilor Americane despre rezultatele interviurilor i vor fi anunai despre statutul lor. Toate dosarele sunt n continuare examinate i evaluate de ctre un panel multinaional de experi n domeniul care vor efectua o analiz scris a proiectelor, bazndu-se pe urmtoarele criterii: Viabilitatea propunerii de cercetare; Necesitatea de acces la resursele academico-profesionale din SUA; Contribuia potenial la dezvoltarea domeniului specific a solicitantului n ara natal. Convorbirile vor fi organizate n limba englez pentru a discuta propunerile individuale de cercetare i beneficiile profesionale a proiectelor la rentoarcerea bursierului din SUA n ara natal, inclusiv posibilele avantaje pentru Centrul regional de Studii Avansate i Educaie (CASE). Finalitii i candidaii de rezerv sunt selectai de ctre specialiti din SUA n baza analizei scrise a proiectelor i rezultatelor convorbirilor orale. Realizarea programului n SUA ncepe n septembrie 2013 i va dura timp de patru luni. Termenul stagiunii de cercetare (nceputul/terminarea) vor fi determinate de NCEEER sau ACTR/ACCELS. Nota Bene: Documentele depuse pentru Programul Carnegie nu vor fi ntoarse candidailor la sfritul competiiei. Informaia indicat n dosare va fi verificat. n cazul discrepanelor sau falsificrilor, dosarul va fi exclus din competiie, candidatul fiind declarat nelegibil.

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INSTRUCIUNI GENERALE: V rugm s citii cu atenie toat informaia i sugestiile nainte de a completa dosarul. FORMULARUL DE PARTICIPARE: Completai formularul de participare n limba englez n form tiprit sau cu litere de tipar folosind cerneal neagr. V rugm s nu omitei seciunile din formular; dosarele incomplete nu vor fi luate n consideraie. Indicai numele i prenumele Dvs pe parte de sus a fiecrei pagini a formularului. FAMILIA: Programul nu ofer suport financiar, asisten pentru obinerea vizei sau scrisori de suport pentru membrii familiilor participanilor n cltoriile lor n SUA. CERTIFICATUL MEDICAL: Bursierii vor trebui s dea dovad de o stare bun a sntii, vizat de medic. Certificatul medical se completeaz n limba englez i va fi trimis finalitilor mpreun cu scrisorile de notificare a statutului lor. Granturile nu vor fi acordate candidailor care nu pot dovedi starea bun a sntii i care nu vor prezenta centificatele medicale completate. PROCESUL DE SELECTARE / PLASAMENT: Toate formularele completate vor fi analizate i evaluate n Statele Unite de ctre o comisie de selectare format din top academicieni americani. NCEEER/Consiliile Americane vor determina semi-finalitii. Candidaii eligibili vor fi invitai la Kyiv/Chisinau i Tbilisi pentru convorbiri personale cu Comisia de calificare multinaional. Plasamentul va fi aranjat de NCEEER sau Consiliile Americane la instituiile i universitile americane n conformitate cu proiectele individuale de cercetare propuse. RECOMANDRILE: Scrisorile de recomandare vor contribui la evaluarea dosarelor de ctre comisia de selectare din SUA. Fiecare solicitant trebuie s nainteze dou (2) scrisori de recomandare de la colegi, profesori i alte persoane calificate care cunosc realizrile profesionale ale participantului. Scrisorile trebuie s poarte semnturile i tampilele oficiale. Scrisorile n limbile romn/rus trebuie s fie nsoite de traduceri n limba englez. Traducatorul trebuie s semneze i s indice numele cu litere de tipar la sfiritul traducerilor. Confidenialitatea scrisorilor nu poate fi garantat. PROPUNERILE DE CERCETARE: V rugm s prezentai propuneri n englez cu volumul de 4-5 pagini n form tiprit sau scris de mn cu litere de tipar. Cea mai important parte a dosarului Dvs este descrierea cercetrii propuse. In proiectul Dvs trebuie s urmai urmtorii pai: Formulai ipoteza Dvs laconic i complet; Descriei obiectivele de cercetare i planul Dvs de a le atinge n Statele Unite; Povestii despre activitatea de cercetare n domeniul propus n cadrul cruia ai lucrat pn acum i relatai legtura acestuia cu proiectul pentru programul Carnegie; Indicai cum vei folosi aceast oportunitate de cercetare n SUA pentru a dezvolta domeniul n ara natal; Descriei cum vei mprti realizrile cercetrii Dvs cu colegii din Moldova, indicnd cum vei informa Centrul regional de Studii Avansate i Educaie (CASE) despre tipul i esena contribuiei Dvs; Mentionai publicaiile pe tematica propus, precum i colegii care lucreaz n acelai domeniu; Indicai cu cine Dvs ai dori s colaborai i ce resurse ai dori s folosii n Statele Unite - colegii americani ce activeaz n domeniul Dvs, arhivele, bibliotecile, etc.; Specificai materialele de care ai avea nevoie pentru cercetare i care nu sunt disponibile n ara natal.

RESUME: V rugm s includei o copie a curriculum vitae (preferabil) sau resume-ului Dvs n englez. In CV, includei urmatoarele: Informaia de contact (adresa, telefonul, email); Informaii despre studiile i gradele tiinifice; Experienele profesionale i de cercetare; Premiile i reuitele profesionale importante; Aptitudinile excepionale i capacitile lingvistice.

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ACORDUL REFERITOR LA INFORMAIA PRIVAT: V rugam s semnai documentul i s-l includei n dosarul Dvs. Semnnd acest document, Dvs suntei de acord cu termenii referitori la informaia privat i permitei NCEEER-ului s-o foloseasc i distribuie n concordan cu metode enumerate. V rugm s contactai oficiul Consiliilor Americane/NCEEER, dac avei ntrebri referitor la formatul scrisorilor de recomandare, propunerilor de cercetare i CV. NOTA BENE: V rugm s detaai formularul de participare i s includei TREI COPII a materialelor cerute mpreun cu originalul. Verificai completarea dosarului conform checklist-ului pe ultima pagina a formularui. Trimitei dosarul i 2 copii la adresa oficiului NCEEER/Consiliilor Americane. Pstrai descrierea programului, termenii de eligibilitate, precum i instrucia de completare a formularului, mpreun cu o copie adiional a tuturor documentelor depuse pentru arhiva proprie. ADRESELE UTILE: Chisinau Alexey Kharlamov The American Councils for International Education: ACTR/ACCELS

str. Kogalniceanu 76 MD-2009 Chisinau, MOLDOVA Tel: (+37322) 225860 Fax: (+37322) 234873
E-mail: alexei@nceeer.org Website: http://www.nceeer.org http://www.americancouncils.md

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S.U.A. NCEEER 910 17th Street NW, Suite 300 Washington, DC 20006 Tel: (202) 296-1677 E-mail: dana@nceeer.org Website: http://www.nceeer.org/

Carnegie Research Fellowship Program


APPLICATION

A Program of the National Council for Eurasian and East European Research (NCEEER), administered in conjunction

with the American Councils for International Education: ACTR/ACCELS, and. supported by a Grant from the Carnegie Corporation of New York.

This application must be completed in English, except where specified. Applications should be typewritten whenever possible, otherwise please PRINT legibly, in black ink. Applications must be RECEIVED by April 30th, 2013 at 5pm (local time for the office to which the application is submitted). All applicants should submit their applications electronically/by email to apply@nceeer.org

The Western NIS office address: American Councils for International Education: ACTR/ACCELS str. Kogalniceanu 76 MD-2009 Chisinau, MOLDOVA Tel.: (+37322) 225860 Fax.: (+37322) 234873

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Please e-mail NCEEER Senior Program Officer Alexey Kharlamov at alexei@nceeer.org with any questions.

THIS APPLICATION MAY BE DUPLICATED AND IS FREE OF CHARGE. 1. NAME Please print your name in Latin letters (as it appears on your international passport if you have one). Do
not translate. .
____________________________________________________________________________________________________ Last Name First Name Middle Name or Patronymic

Attach recent photo

2. GENDER (please circle one):

Male

Female

3. CITIZENSHIP ___________________________________ 4. AGE _______ 5. DATE OF BIRTH_____/______/________


Month Day Year

6. PLACE OF BIRTH
city: _____________________ country:___________________

7. MAILING ADDRESS (the address at which you receive your mail)


____________________________________________________________________________________________________ Country City Postal Index

____________________________________________________________________________________________________ Street Name House/Apartment Number

(_________) _______________ _______________________ _____________________________________ City code Telephone (home) Another contact telephone E-mail address

8. DISABILITY

___YES ___NO

Information for statistical and logistic purposes only; answer will not affect the outcome of your application. If yes, please describe your disability (i.e. hearing impaired, visually impaired, etc.)

_______________________________________________________________________________________ _______________________________________________________________________________________ 9. INTERNATIONAL PASSPORT NUMBER (if applicable)

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_________________________________________________________________ 10. CURRENT WORK ADDRESS IN ENGLISH


________________________________________________________________________________________________________ Name of Institute or Organization Professional Title Country (_________) _________________ City code Telephone (work) City _______________________ Fax Type of Organization Department Postal Index __________________________________________ E-mail address ________________________________________________________________________________________________________ ________________________________________________________________________________________________________

11. YOUR SPECIALIZATION OR SUBFIELD ____________________________________________________________________________________ 12. TITLE OF PROPOSAL


Please be as descriptive and specific as possible. If selected, the title of your proposal will be extremely important in arranging your placement.

_______________________________________________________________________________________
________________________________________________________________________________________________________

13. PROVIDE A BRIEF SUMMARY OF YOUR RESEARCH PROPOSAL


Please limit your summary to 30 words or less. Your full five to seven page proposal should be attached to this application.

_______________________________________________________________________________________ _______________________________________________________________________________________ _______________________________________________________________________________________ 14. PROPOSED U.S. UNIVERSITY/ORGANIZATION AFFILIATION


Please list universities in order of preference. Please list contact information (professors name, phone and e-mail address) whenever possible. We cannot guarantee your preference for placement.

_______________________________________________________________________________________ _______________________________________________________________________________________ _______________________________________________________________________________________ _______________________________________________________________________________________ _______________________________________________________________________________________ _______________________________________________________________________________________ 15. CARNEGIE RESEARCH FELLOWS ARE OFTEN ASKED BY THEIR HOST UNIVERSITIES TO TAKE PART IN DISCUSSIONS, SUCH AS GRADUATE SEMINARS, RELATED TO THEIR FIELDS. FROM TIME TO TIME, THEY ARE ALSO ASKED TO SPEAK ABOUT CURRENT SOCIAL, POLITICAL AND ECONOMIC SITUATION IN RUSSIA, RUSSIAN VIEWS OF AMERICA, AND SIMILAR MORE GENERAL TOPICS. ARE YOU WILLING TO TAKE PART IN ACTIVITIES SUCH AS THESE? ARE THERE PARTICULAR ISSUES OR SUBJECTS THAT YOU WOULD BE INTERESTED IN SPEAKING ABOUT? ___YES ___NO
If yes, please name them.

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_______________________________________________________________________________________ _______________________________________________________________________________________ 16. EDUCATIONAL BACKGROUND


Please list all institutions attended after school. Do not translate degree titles. University Name and Location Field of Study Dates Degree & Date Received

_______________________________________________________________________________________ _______________________________________________________________________________________ _______________________________________________________________________________________ _______________________________________________________________________________________ 17. PROVIDE YOUR EMPLOYMENT HISTORY IN REVERSE CHRONOLOGICAL ORDER
Include the past ten years. Job Title Employer Name Address Dates

____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ 18. LIST COURSES TAUGHT OR CURRENTLY TEACHING, AND APPROXIMATE NUMBER OF STUDENTS THAT
YOU TEACH EACH YEAR

____________________________________________________________________________________ ____________________________________________________________________________________ 19. LIST PUBLICATIONS IN SCHOLARLY JOURNALS/PERIODICALS IN REVERSE CHRONOLOGICAL ORDER
Do not translate titles. Article or Monograph Title Publisher & City Year

____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ 20. INDICATE ANY ACADEMIC OR PROFESSIONAL HONORS RECEIVED, INCLUDING DATES

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____________________________________________________________________________________ ____________________________________________________________________________________ 21. LIST PROFESSIONAL ACTIVITIES


Please include affiliations, significant honors, and accomplishments.

____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ 22. KNOWLEDGE OF ENGLISH AND OTHER LANGUAGES


Native Language: _________________________ Beginning with English, list all languages you know and rate your reading, writing, listening, and speaking skills in each language, using Excellent, Good, Fair, and Poor. Language Reading Writing Listening Speaking

1. ENGLISH __________________________________________________________________________________ 2.____________________________________________________________________________________________ 3.____________________________________________________________________________________________ 4.____________________________________________________________________________________________

23. TOEFL TESTING. If you have taken the Test of English as a Foreign Language (TOEFL), please give the date
and location where you took the examination, and your scores. If you have a copy of the test scores, please attach a photocopy of your score reports to this application. (The TOEFL is NOT required for applicants to the CRFP.) ______________________________________________________________________________________________ ______________________________________________________________________________________________

24. CURRENT ENGLISH TRAINING (OPTIONAL): Describe what you are doing now or plan to do to increase your
English-language proficiency. ______________________________________________________________________________________________ ______________________________________________________________________________________________

25. TRAVEL ABROAD FOR THE LAST FIVE YEARS (Please give year and place)
______________________________________________________________________________________________ ______________________________________________________________________________________________ ______________________________________________________________________________________________

26. U.S. TAX INFORMATION

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a. If you have ever received a Social Security number or Tax Identification Number from the U.S. government, please list: ________ - _____ - ________ b. If you have neither of the aforementioned numbers, please provide the following information for tax purposes: ________________________________________________________________________ Mothers maiden (before marriage) last name, first name, middle name or patronymic. ________________________________________________________________________ Fathers last name, first name, middle name or patronymic. CERTIFICATION: I certify that the information given in this application is complete and accurate. I certify that I completed this application myself, without any aid or assistance. If selected, I agree to comply with all regulations of the Carnegie Research Fellowship Program and to return to my home country upon completion of my research program. I understand that my program may be terminated for giving false information, for general misconduct, or for any other reason. I understand that this program excludes accompanying spouse and/or children. __________________________________________________________________________________________ Signature of applicant Date

Privacy Policy of the National Council for Eurasian and East European Research (NCEEER) on Information Concerning Candidates and Participants in Its Programs
Information on program candidates and participants is essential to NCEEER in order to carry out its programs and evaluate their quality and effectiveness, as well as for the development of new programs. NCEEER strictly observes the confidentiality of information obtained from the candidates and participants in its programs and uses this information in accordance with the principles outlined in this document. The principles in this document apply only to NCEEER. Other organizations involved in the administration of these programs may adhere to similar or different policies in working with information on program candidates or participants.

1. Type of information and means of information collection Information on program candidates and participants consists of the testimony obtained from them in filling out their application forms, the conducting of interviews, and the process of completing the program, as well as data pertaining to program administration. This information, along with contact information, and information on education, professional experience, and work place, may also include personal information. NCEEER preserves this requested information in both written and electronic forms. Some datafor example, contact informationwill be continually updated, in order for representatives of NCEEER to maintain connections with participants, with the goal of sharing information on new programs and projects, and also for the evaluation by participants of program effectiveness. 2. Use of Information Information is used: In the evaluation of your candidacy by the selections committee For presentation to the organizations which finance this program For presentation to potential participating schools, universities, or other organizations, with the goal of future participation in their academic and professional programs, and also in host families For the evaluation of the effectiveness of your participation in the program and your compliance with norms and rules outlined by the program For the timely notification of program graduates of forthcoming meetings and new programs and projects in which they can take part For data collection in evaluating the effectiveness of the programs being conducted

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For conveying to financial establishments and organizations invited by NCEEER to evaluate the effectiveness of the programs being conducted For conveying to participants and graduates of programs, financed by the United States government, with the goal of creating connections between graduates For conveying to non-profit organizations with the goal of cooperating in program graduates professional development Information about the individualscandidates and program participantsalso may be used by NCEEER, financial organizations, or their representatives, for government statistics and evaluation of program research. The data analyzed in these activities may be published only as part of statistical data. Personal data will not be published. Exceptions are contact information, details relating to academic programs, professional placements (location where the program took place; schools, universities, and other host organizations; discipline; and research theme) and to attract graduates to future post-program activities (participation in meetings for graduates and small grant programs), and also those materials, which participants or program graduates present to NCEEER (provided they are not copyrighted). By signing this document, you indicate your agreement to the collection, use, storage, and dissemination of information about you in accordance with the conditions laid out above.

______________________________ Signature ___________________________________________ Full Name (printed)

__________________ Date

Application Checklist Have you included: Your completed application? (Be sure to keep a copy for your records.) Two letters of recommendation (with official stamps)? Your five to seven page research proposal? Your curriculum vitae or resume? A clear photocopy of your international travel passport (if available)? Signed Privacy Policy Agreement?