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APPLICATION
for the U.S. Information Agency FY 1997 Regional Scholar Exchange Program and FY 1997 FSA Fellowships in Contemporary Issues
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Personal and Professional Data
1 NAME: Last First Middle
2
GENDER:
Male
Female
3 CITIZENSHIP:
4 AGE: DATE OF BIRTH:
5 PLACE OF BIRTH (City, Country):
6
MARITAL
STATUS: Single
Married Separated Divorced Widowed
7 CURRENT HOME ADDRESS:
Street_______________________________________________ Apt ________________
City________________________________ Country Index______________________
Telephone__________________________ Alternate Telephone___________________
___________________________________________________________________________
8 FIELD OF RESEARCH: ___________________________________________________________________
(Select one Regional Scholar academic discipline or Contemporary Issues research topic from pages iv-v).
PROPOSAL TITLE:
Deadline: Friday October 31, 1997, 5:00 p.m.
WELCOME
TO THE UNITED STATES CUSTOMS
DECLARATION
Each arriving traveler or head of family must
provide the following information (only ONE declaration per family
is required)
1.
Name: ………………………………………………………………………………. Last First Middle 2.
Date of Birth: ………………………………. 3.
Airline/Flight: …………………… 4.
Number of family members traveling with you ……………………………………. 5.
U.S.Address: ………………………………………………………………………... 6.
I am a U.S.Citizen Tick
boxes YES
NO If
No. Country: …………………………………………………….
7.
I reside permanently in the U.S. Tick
boxes YES
NO If
No. Country: …………………………………………………….
8.
The purpose of my trip is or was Tick
boxes BUSINESS
PLEASURE 9.
I am/we are bringing fruits, plants, meats, food, soil, bircs,
snails, other live animals, farm products or YES
NO I/we
have been on a farm or ranch outside the U.S.
10.
I am/we are carrying currency or monetary instruments
over $10,000 U.S. or YES
NO foreign
equivalent.
11. The total value of goods I/we purchased or
acquired abroad and am/are bringing
to the U.S. is (see instruction under
Merchandise on reverse side): $ ………………… U.S.Dollars
MOST MAJOR CREDIT CARDS ACCEPTED
SIGN ON REVERSE SIDE AFTER YOU HAVE READ THIS WARNING
(Don’t write below this line) Inspectors Name Stamp area Badge No.
PLEASE TURN OVER
Ex. 16. Write a brief biographical account of any famous historical figure. Look
Ex. 16. Write a brief biographical account of any famous historical figure. Look for information in different sources.
Ex. 17. Write a short biographical sketch of any character in a novel of a film that you know well enough.