THE REPUBLIC OF THE UNION OF MYANMAR FEDERATION OF CHAMBERS OF COMMERCE AND INDUSTRY

NO.29, MIN YE KYAW SWAR STREET, LANMADAW TOWNSHIP, YANGON, MYANMAR

(ESTABLISHED. 1919)

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Application

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Original completed application form

o Project statement (3-5 pages typed)

o Professional resume/curriculum vitae

Bibiolography ( up to 3 pages: this is required for research or combined

teaching/research awards)

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A copy of your academic transcripts

Three letters of recommendation

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16 :18851511068

AMEMBAS SV VANGON

R'l'llj r

r , vv r

Embassy of the United Slates of America

September 9/ 2015
Director General
Foreign Economic Relations Department
Ministry of National Planning and Economic Development
Nay Pyi Taw, Myanmar
Dear'Director General,
It is with great pleasure that the Embassy of the United States of America has an opportunity to
nominate participantjs) to conduct scholarly research in the United States through the Fulbright
U.S.-ASEAN Visiting Scholars Initiative.

'The Fulbright U.S.-ASEAN Visiting Scholar Program is open for application to all university

faculty, ministry officials, and professional staff of NGOs to travel to the United States for three to

four months in late 2016 to conduct scholarly and professional research on issues that are useful

to ASEAN member nations and central to the U.S.-ASEAN relationship. 'This program seeks to

enhance mutual understanding and cooperation through educational and cultural exchange.

The Department of State makes the final selection of program participants and covers all expenses

related to the program in the United States/ including international round-trip airfare, lodging,

and meal expenses. Participants In this prugram must have excellent English skills. Attached are

the program announcement and application form.

The Embassy would like to request assistance in distributing the information to other ministries

and looks forward to receiving applications for the scholarship program from ministry officials.

The Embassy requests that the applicants submit soft copy application forms to

RangoonUSECA@state.gov or hard copy application forms to the Cultural Affairs Unit, Public

Affairs Section, American Embassy, 110 University Avenue, Kamayut Township, Yangon, no later

than October 15, 2015.

Further program details can be found on the Embassy's official website:

http://burma.usembassy.govIfulbright-asean.html. Additionally, lor Cultural Affairs Assistant

Daw Saw Kyi Tha will be pleased to provide further information on the program if requested.

My office phone number is 01-536-509, x 4215 and Daw Saw Kyt Tha's office number is 01-536

509, x 4369. I look forward to receiving applications for the Fulbright U.S.-ASEAN Visiting

Scholar Program from ministry officials.

Sincere!J:._.,

->. -, (~

/-L-_.
.~._. . .

."'::--..c.:::a

Sarah Quinzio
Cultural Affairs Officer

-----....

2016 FULBRIGHT U.S.-ASEAN VISITING SCHOLAR PROGRAM

Program Summary
The U.S. Embassy in Yangon is pleased to announce the 2016 U.S.-ASEAN Visiting Scholar Program.
WHAT: Conduct scholarly, professional research and lecture in the United States for 3-4 months in late 2016; seek
opportunities to provide an ASEAN perspective through guest lectures, seminars, or participation in academic or
professional conferences.
WHO: Open to all university faculty, ministry and government officials, and professional staff in the private sector,
think tanks, and NGOs.
FIELDS OF STUDY: Any issue that is relevant and useful to ASEAN member nations and central to the U.S.-ASEAN
relationship, including but not limited to: Education, Environmental Sciences, Financial Market Integration, Food
Technology, Information Sciences, Journalism, Law, Political Science, Public Administration, Public/Global Health,
Statistics, Trade and Investment, Trade Facilitation, Teaching English as a Foreign Language, and many others.

Eligibility
An applicant:
must be a Myanmar citizen;
must hold a Bacheior's Degree or higher;
must be proficient in English (minimum TOEFL 550). Note: You do not need a TOEFL score to apply for this
program, but you may be asked to take the TOEFL during the application process;
should have relevant degrees or professional experience in the proposed field of study;
should have little or no previous experience studying or working in the United States;
must be able to take leave from home institution or post.

Application
A complete application set includes:
1. Original completed application form
2. Project statement (3-5 pages typed)
3. Professional resume/curriculum vitae
4. Bibliography (up to 3 pages; this is required for research or combined teaching/research awards)
5. A copy of your academic transcripts
6. Three letters of recommendation

The deadline for applications is October 15, 2015

For application and instructions, please visit http://burma.usembassy.gov/fulbright-asean.htmlor contact us at
Cultural Affairs Unit, Public Affairs Section, American Embassy, 110 University Avenue, Kamayut Township, Yangon,
Ph: 01- 536509/505113 Ext: 4369, 4869, email: RangoonUSECA@state.gov. Follow us on Facebook at
http://www.facebook.com/usem bassy.rangoon.

......

FULBRIGHT

Fulbright Scholar ProgramVisitingScholar ApplicationForm

I.Home Country/CountryApplyingfrom:
2.Program :

Fulbright Visiting Scholar Program

3.Specialawardname :
CohortDiscipline: ...,nJ'-"a'-
Fulbright U.S.-ASEAN Visiting Schol ar Initiative

forFulbrighIVi,il ingScholarProgramforlraqapplicanlsonly:

4.Categoryofgran t:

6.

5. Title:

Gender:

8. Countryofcitizenship:

_
_

9. Countryoflegalresidence:

7. FamilyName/Surname:

First:

Middle :

10. Doyouhave orare youapplyingforU.S.permanentresidency(i.e. greencard)?

II . Date otbirth :
12. U.S.SociaISecurityNumber:

Place otbirth:

No
----,=,.,,-

-::':'T.::-
CIl)'

country

StartDate:

13.Current position :

Other:
DepartmentName:

InstitutionName:

Clickhere ifindependentscholar/unaffiliated(please enteryourresidence address)

Address :
street

CIty

province/state

coun try

/xM,talCOJe

Email :
Phone:

Fax :

14.Academic credentials (degrees-listthree high est degrees):

Name oflnstitutionOne:
Discipline

Degree

DateReceived

CityandCountry

Discipline

Degree

DateReceived

Name oflnstitutionThree:
CityandCountry

Discipline

Degree

DateReceived

CityandCountry

Name oflnstitutionTwo:

15.Mostsignificant professional accomplishments, honors andawards anduptothree significant publications:

16.PreviousFulbrightgrants:

DYes

DNo

(Ifyes,listmostrecentfirst)

17.Projecttitle and Project statement (3-5 pages typed)

IS.Briefs urnmaryofprojectsta temen t: Notapplicablefor Fulbright Visiting Scholarl'rogramforlraq applicants.

Name (Last First, Middle)

PROGRAMIPROFESSIONALINFORMATION
19.Number ofmonths requiredfor project:(No/applicable for FulbrighrVisiting'Scholar Programfor /raqapplicants.)
months
a.Beginyour project:
b.Endyourproject:
20.Majoracademic discipline
21.Spccialization(s) (listsub-fields withinthe academic discipline) :

22.A. State Department FieldofStudy

I3.PrimarySpecialization
23.Professionaltravelandlorresidence abroad duringthe lastfiveyears.

Country

HowLong

Purpose ofActivity

J CategoryofSponsorship
24 .Professional Memberships (cultural, educationalandprofessional organizations)

Organization

HowLong

Your Role

25.Refcrences
Referee One Familyname:

First:

Institution:
Address:
country
Phone :

city
Email:
Referee Two Familyname:

Fax:
First:

Institution :
Address:

CIty

country

Email:

Phone :

Referee ThreeFamilyname :

Fax :
First:

Institution:
Address :

country

clfy

Phone :

Email :
26.Self-assessment ofEnglishproficiency:
Reading:
Is Englishyour native language?

Writing:

Speaking:

Fax:

Name(Lasl Firsl .Middle)

27 .Preferredhosti nst itution(s):

of
invitation.lf
I fyoumadearrangementsfor
affi liationwithaU.S.
hostinstitution,providethefoll owinginformationandattachyourletter
that
these
youhavenotmadearrangementsforaffiliation,identi/)'threepreferences.Besuretogivedetailedreasonsforeachchoice,andconfirm
universities offer programsinyourfieldofinterest.

I.

Professor:
_

Department:

Phone:

Fax:------------Email:

IAstitHtisA}lame :

-==---D

Address:

--'==-_ _

Willyoubeattachinga letterofinvitationinthedocumentuploadsection?Yes
No
If you havenotobtaineda letterofinvitation,pl easeprovidereasons forsuggestedaffi Iiati on:

o
Initialcontact made:

2.

Letter of invitationexpected:

Professor:Department: Phone.Fax.Email:
InstitutionName:

Address:

Willyoubeattachinga letterofinvitationinthedocumentuploadsection?Yes
No
If you havenotobtaineda letterofinvi tati on,pleaseprovidereasonsforsuggestedaffil iati on :

Initialcontact made: 0

3.

Letter of invitalionexpected:

Professor:Department:Phone:Fax:Email:
InstitutionName:

Address:

Willyoubeattachinga letterofinvitationinthedocumentuploadsection?Yes

No

I f you haveeetebteinede IetteroHIl,..itati Oil ,pI easepro'iidereasollsforstlggestedaffil iati Oil :

Letter of invitationexpected:

Initialcontact made:

_ Name (Last First, Middle)

28.Home MailingAddress
Address :
street

--:=,--

city
country

province/state

postalcode

Phone :

Email:

Fax:

29.EmergencyContactlnformation
Familyname:
First:
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _Address:

-'Middle:

slreel

eity

province/state

country

postalcode

Phone:

Email:

Fax:

30.MaritaIStatus:
3l.Names ofdependents:(Not applicable for Fulbright Visiting ScholarProgramforIraq applicants.)
DependentOne: Relationshiptoyou Lengthofstayinthe US:Gender:Fami1yname: First: Middle :Date ofBirth: .1O.Place ofbirth :
CountryofCitizenship:
_ CountryotResidence :
CIty

countrY

DependentTwo: Relationshiptoyou Lengthofstayinthe US:Gender:Fami1yname: First: MIddle : Date oflsirth: .IO.Place ofbirth:
CountryofCitizenship:

CountryotResidence:

_
country

CIty

DependentThree: Relationshiptoyou Lengthofstayinthe US :Gender:Familyname: First: Middle:

Date ofBirth:
IO.Place ofbirth:
cuy
CountryofCitizenship:
_ CountryotResidence:
.L.'

DependentFi ve:

-----

IO.Place ofbirth:

cuy

CountryotResidence:

Relationshiptoyou - - Familyname:

Date ofBirth :...

CountryofCitizenship:
DependentSix:
Relationshiptoyou
_ _ _ _ _Familyname:
Date ofBirth: .
CountryofCitizenship:

Gender:
Lengthofstayinthe US: _ _ _ _
First:
Middle:

DependentFour: Relationshiptoyou
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _Familyname.
Date oflsirth,
CountryofCitizenship:

tormrry

country

Lengthofstayinthe US:_____
Gender :
First :
Middle:

IO.Place ofbirth:

cuy

CtJuniry

CountryotResidence:
Lengthofstayinthe US:.,..
Middle:

First:
IO.Place ofbirth:

dl)'

CountryotResidence:

_
_

Gender:
_
cuunlijl

32.Doyouexpecttoreceive sabbatical pay, paid leave ofabsenceor

othersources of financialsupportduringyour Fulbrightgrant?
IfyouansweredYes, please specify
source(s)andarnountinU.S.dollars. Please
entertotalamounts fortheexpected grant
period,ratherthanmonthlyamounts.

DYes

No

Sources

Amount

33.HowdidyouleamabouttheFulbrightVisitingScholarPrograrn?

o FriendorRelative
o FulbrightAlumnus
o PosterlFlyer
o University(specify)

o
o
o

Newspaper(specify)
OtherPublication(specify) FulbrightWebsite (specify) OtherWebsite (specify)
Other(describe)

o
34.Ho~mgdidyouconsiderapplyingfora FulbrightVisitingScholarawardbefore submittingthis application?

35.Beyondthe reputationoftheFulbrightprogramitself,whatwere the majorfactors inhelpingyoudecide toapplyfora FulbrightVisitingScholaraward?

Publicityaboutthe program
Advice ofa colleague
Advice ofaformerFulbrighter
Timewas rightinmycareer
Other(please describe)

36.Physicalimpairment(please describe.ifany):

.
By rnysignature below,Icertifythattothebest ofmy knowledge,the informationprovidedinallparts ofmy applicationis
accurateandcomplete.I understandthatfinalapproval ofmyapplicationisdependeiltuponmyeligibilityfora J Visa inthe United
States.Iagree toreturntomyhome countryuponthe expirationofmy authorizedstayinthe UnitedStates.
Signature:
Date: