Fulbright Greece - Visiting Research Students Registration Form

Before your register carefully read all instructions of the Fulbright scholarship program of your choice as announced on the Foundation's website. Complete all required fields using a combination of upper and lower case letters (do not use just one or the other).

YOUR PERSONAL DETAILS

Please upload a photo(*)

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TITLE(*)

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First name(*)

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Following passport/ID

Last Name(*)

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Following passport/ID

DATE OF BIRTH(*)

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CITY & COUNTRY OF BIRTH(*)

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COUNTRY OF CITIZENSHIP(*)

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(if you hold dual citizenship, please specify both)

COUNTRY OF PERMANENT RESIDENCE(*)

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HOME PHONE

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MOBILE(*)

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EMAIL ADDRESS(*)

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YOUR CURRENT CURRICULUM

DEGREES EARNED(*)

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(institution / degree level / field / year)

CURRENT SPECIALIZATION(*)

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DEPARTMENT & UNIVERSITY(*)

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Ph.D. Start Date(*)

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As start date we consider the date of your Ph.D. application acceptance and the assignment of the 3-member Advisory Committee as certified by your home institution.

NAME AND TITLE OF YOUR SUPERVISOR(*)

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Committee Members(*)

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Please provide the names and titles of two additional Advisory Committee Members

Ph.D. Thesis Title(*)

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YOUR OBJECTIVES

U.S. UNIVERSITY / INSTITUTION AFFILIATION AND ACADEMIC CONTACT(*)

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PROPOSED U.S. PROJECT / RESEARCH TITLE(*)

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PLEASE UPLOAD A COPY OF YOUR CURRICULUM VITAE INCLUDING ACADEMIC QUALIFICATIONS (file size up to 2 MB)(*)

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(publications,symposia,conferences …)

PLEASE UPLOAD A SHORT VERSION OF YOUR STUDY RESEARCH OBJECTIVE INCLUDING PROJECT DETAILS (file size up to 2 MB)(*)

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(max. 1 page including background, methodology, objectives, relationship to the objectives of the Fulbright Program, the impact and benefits of your proposed U.S. based research for Greece, and Ph.D. timeline: current status and stage, feasibility of your planned research within the proposed grant period, expected completion date).

PLEASE UPLOAD A WRITING SAMPLE IN ENGLISH (file size up to 2 MB)(*)

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(a chapter of your thesis or a published conference paper)

DID YOU HAVE ANY ACADEMIC AND/OF PROFESSIONAL EXPERIENCE IN THE U.S. DURING THE LAST 10 YEARS?(*)

YesNo Invalid Input

IF YES, PLEASE LIST PURPOSE(S), LOCATION(S), AND DATES

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Did you visit the United States during the last 12 months?(*)

YesNo Invalid Input

Do you plan to travel to the United States in the next 6 months?(*)

YesNo Invalid Input

HOW DID YOU LEARN ABOUT THE FULBRIGHT STUDENT PROGRAM?(*)

ACKNOWLEDGEMENT AND ACCEPTANCE(*)

I have read and understood the selection criteria, eligibility requirements, and Fulbright Greece Terms & Conditions / Privacy Statement. Invalid Input

J1(*)

I am fully informed about the J1 Visa two-year-home residency requirement and its implications. Invalid Input

CERTIFICATION (*)

By signing below, I certify that the information provided in this form and any attached documents is true and correct. I also understand that any willful dishonesty may render for rejection of my registration. Invalid Input

Place and Date

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Digital signature (use your mouse as pen)(*)

Sign Above

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Captcha(*)

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Visiting Research Students Registration Form

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