FULBRIGHT PROGRAM AFGHANISTAN

APPLICATION FORM FOR FULBRIGHT MASTERS AND DOCTORAL PROGRAMS 2017-2018 Cohort
Fulbright Foreign Student Application Checklist
***READ THE CHECKLIST CAREFULLY BEFORE COMPLETING APPLICATION***

Application
Form

Citizenship
Requirement
Personal
Identity

Follow the instructions carefully and answer all questions completely.

Each part of the application form must be completed in English. Incomplete applications will not be
considered.
Use the tab key to move from field to field; Do not exceed the space provided in text boxes.
Must be Afghan citizens, with a permanent residence in Afghanistan.
Permanent residents of other countries are not eligible.
All Fulbright programs in Afghanistan provide support for the recipient ONLY. Dependents, including
spouses cannot accompany the recipient.
Applicant must enter his/her personal information accurately as it appears (or will appear) on
his/her passport.
Must have minimum TOEFL/iBT score of 75 for Masters Programs and at least 80 for Doctoral
Programs to be selected as a finalist.
A screenshot of your TOEFL score should be included in the application package.
Scores from PBT of at least 550 or IELTS of at least 6.5 are acceptable to pass the initial technical
eligibility review.
No TOEFL score yet? Please register on the ETS website: www.ets.org.
Practice TOEFL tests completed at sponsored locations and times are acceptable to pass the
technical eligibility review.
GRE or GMAT score not required until being selected as a finalist or alternate for the Fulbright
program.
If you have already a GRE or GMAT scores, please provide the information in the Application Form.
A clearly articulated study objective or academic goal statement is an important component of your
Application Form. This is your opportunity to state what you want to study and to achieve.
To learn more about how to prepare an essay, click here.

A narrative statement describing how you have achieved your current goals.
Highlight your strengths and address any inconsistencies or perceived weaknesses.
To learn more about how to prepare a Personal Statement, click here.
An up-to-date curriculum vitae (CV) or resume is required and is part of the application package.
3 letters of recommendation from academic instructors, professors or work supervisors are required.
Letters of recommendation must NOT be written by applicants relatives or friends.
All recommendation letters must be scanned and included in the application package.
To learn more about how to prepare a recommendation letter, click here.

A four-year bachelors degree with eight (8) semesters of graded transcripts is required for the
Masters program.
Applicants with three-year degrees (for example, from some universities of the U.K., India or
Pakistan) must have an additional one-year diploma and transcript of two semesters or one year of
graduate studies toward a Masters degree.
All documents (diplomas and transcripts) must be attested by the Afghan Ministry of Higher
Education (MoHE) and Ministry of Foreign Affairs (MoFA).
Applicants who have completed their bachelors degree before March 20, 2015 but have not
received their official diploma, may, in lieu of the diploma, attach an official letter from the Ministry
of Higher Education, certifying their graduation as well as their final transcript evidencing
attainment of a bachelors degree. However, such applicants must provide official diploma as soon
as possible.
Ph.D. applicants must provide a copy of their diplomas of four-year bachelors degree and two-year
Masters degree.
All documents, including diploma, transcripts, and recommendation letters, must be translated by
an official translation company or a certified translator.
Only required for Ph.D. applicants; Research paper, published article, paper done for a course are all
acceptable.
University preference is not expected.
Please specify your preference of department and program.
If you are in correspondence with a faculty member, please provide the name and contact
information of the faculty.

Standardized
IBT TOEFL
Test

GRE and
GMAT
Study
Research
Objectives
Personal
Statement
Resume/CV
Letters of
Recommendat
ion

Diploma(s)
and
Transcripts

Translation of
Documents
Writing
Sample
University
Preference

Supplemental
Materials
(Check
when
completed)

Submitting
Complete
Application

A complete application should include the following components

Completed Application Form
recommendation letters
Checklist
Copy of Transcripts

Screenshot of TOEFL/IELTS score

Copy of three
Updated CV
Copy of Diploma(s)

Application

Applicants must print out this Checklist form, sign, scan and convert it, with the completed Application
Form and the rest of the Supplemental Materials, into one single PDF file with maximal 5 MB file size.
The PDF file name should include your full name and field of study. The complete PDF and Word files
must be submitted via email to KabulScholarshipInfo@state.gov before the deadline (11:59pm Kabul
time on March 20, 2016). The subject line of your email must also include your full name and field of
study.
Applicant Name: _________________________________
Applicant
Signature:________________________________Date:_______________________________

FULBRIGHT PROGRAM AFGHANISTAN

APPLICATION FOR STUDY IN THE UNITED STATES
(Please read instructions carefully. All sections must be completed in English and be typewritten.)
1. PERSONAL INFORMATION:
Gender:
Male
Female
Last Name:
First Name:
Date of Birth*: (Month-Day-Year):
Current Age:
Birthplace: (City, Province)
Country of Birth:
National Identification Number/Tazkira:
Marital Status:

*This should match the date listed on your passport

Do you now have, or have you ever held: U.S. citizenship?

Do you have dual citizenship with any other country?
do you have U.S. lawful permanent residency (Green Card)?

Yes

Yes
Yes
No

No
No

2. PAST VISA APPLICATIONS:

A. Have you ever applied for the visa lottery (diversity visa)? If so, please list the year(s) you applied. If someone else
has applied on your behalf, or if your spouse or child has applied, please also include that information.

B. Has anyone ever filed an immigrant visa petition on your behalf or on behalf of your spouse or child? If so, list their
name, relationship to you and when they filed the petition.

C. Have you, your spouse, or child ever applied for a Special Immigrant Visa? If so, please specify who, when, and what
is the current status.

D. Have you ever applied for any other type of visa? If so, please list when, and what was the result.

E. Are you aware of any factor that might make you ineligible to receive a U.S. visa? If so, please explain.

F. Have you travelled to any European country, Canada, Australia or New Zealand over the past five years? If yes, where
and when have you travelled?

3. PERMANENT MAILING ADDRESS:

Street:
City:
Province:
Country:
Telephone:
Mobile Phone 1:
Mobile Phone 2:
E-mail:
4. EMERGENCY CONTACT IN AFGHANISTAN:
Name, address, email and telephone number of individuals to be notified in case of an emergency:
Name:
Phone:
E-mail:
Relation to you:
5. INFORMATION ON FAMILY/CONNECTIONS IN THE UNITED STATES:
Please provide Name, Address, E-mail and Telephone number of individual contacts, relatives, or family members in the
United States or Canada:

6. MEDICAL, PHYSICAL, DIETARY OR OTHER PERSONAL CONSIDERATIONS:

Please state if you have any existing medical conditions or are currently taking any prescription medication. This will not
affect candidate selection, but will enable the host institution to make any necessary accommodations.


7. EDUCATIONAL BACKGROUND
LIST EDUCATIONAL INSTITUTIONS ATTENDED IN REVERSE CHRONOLOGICAL ORDER, INCLUDING ANY IN WHICH YOU MAY
BE PRESENTLY ENROLLED:
INSTITUTION AND LOCATION
(List in reverse order and
write name in full)

MAJOR FIELD OF
STUDY

DATES
(Month and Year)
From
To

ACTUAL NAME OF
DEGREE OR DIPLOMA
(Do not translate)

DATE RECEIVED
OR EXPECTED

FULBRIGHT STUDENT STUDY PLANS IN THE UNITED STATES

8. DEGREE OBJECTIVE:

Masters

Doctorate

9. PROPOSED FIELD OF STUDY FOR DOCTORAL APPLICATIONS (Do Not Attach Additional Sheet)
1.
2.
3.

Agriculture
Communications
Economics

4.
5.
6.

Education
Engineering
Math

7.
8.

Science
Technology

PLEASE TYPE HERE YOUR SELECTED FIELD OF STUDY FROM THE ABOVE LIST

10. PROPOSED FIELD OF STUDY FOR MASTERS APPLICATIONS (Do Not Attach Additional Sheet)
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
23.
24.
25.
26.
27.
28.
29.
30.
31.
32.
33.
34.

Accounting/Finance
Agriculture
Animal Science
Anthropology
Archaeology
Architecture
Area Studies
Art History
Arts
Astronomy
Biology
Biomedical Engineering
Business
Chemistry
Communications
Computer Science
Criminal Justice
Criminology
Crop Sciences
Dance
Demography
Design
Drama/Theater Arts
Economics
Education
Energy

35.
36.
37.
38.
39.
40.
41.
42.
43.
44.
45.
46.
47.
48.
49.
50.
51.
52.
53.
54.
55.
56.
57.
58.
59.

Engineering
Environmental Sciences
Film/Cinema Studies
Fine Arts
Fisheries
Forestry
Gender Studies
Genetics
Geography
Geology
History
Information
Sciences/Systems
International Relations
Journalism
Labor/Industrial Relations
Language Teaching
Languages
Law
Library Sciences
Linguistics
Literature
Mathematics
Meteorology
Museum Studies

60.
61.
62.
63.
64.
65.
66.
67.
68.
69.
70.
71.
72.
73.
74.
75.
76.
77.
78.
79.
80.
81.
82.
83.
84.

Music
Neuroscience
Nursing
Nutrition
Oceanography
Paleontology
Pharmacology
Philosophy
Physics
Physiology
Political Science
Psychology
Public Administration
Public Health
Public Policy
Social Work
Sociology
Telecommunications
Theology/Religion
Transportation
Travel/Tourism
Urban Planning
Urban Studies
Veterinary Medicine
Zoology

PLEASE TYPE HERE YOUR SELECTED FIELD OF STUDY FROM THE ABOVE LIST

11. CURRENT EMPLOYMENT

Write the position title which best describes the activity in which you are currently employed.

A. IF YOU ARE CURRENTLY EMPLOYED BY A BUSINESS OR ORGANIZATION, PLEASE WRITE THE NAME OF
THAT BUSINESS OR ORGANIZATION:
B. HOW LONG HAVE YOU WORKED FOR YOUR CURRENT EMPLOYER?
C. PLEASE SELECT YOUR TYPE OF EMPLOYER FROM THE LIST BELOW:

National Government Institution

Provincial Government Institution
District Government Institution
City/Rural Government Institution
International Non-Governmental Organization (Non-Profit)
Local/National Non-Governmental Organization (Non-Profit)
Private Sector Business
Public University
Private University
Self-Employed (please specify)
Other (please specify)

D. IN YOUR CURRENT POSITION, DO YOU MAKE POLICY DECISIONS IN YOUR BUSINESS OR

ORGANIZATION? (Example: Are you in a management/executive-level position?) YES/NO
E. IN WHICH PROVINCES IS YOUR BUSINESS OR ORGANIZATION ACTIVE? (If the business or organization is
active in all provinces, write nationwide, if it is active internationally, write international).
F. IF YOU ARE SELF-EMPLOYED, WHAT IS YOUR PROFESSION AND CURRENT POSITION?:
G. IF YOU ARE UNEMPLOYED, WHAT WAS YOUR MOST RECENT EMPLOYER AND POSITION?:
H. HOW MANY YEARS OF TOTAL WORK EXPERIENCE DO YOU HAVE?
12. OCCUPATIONAL EXPERIENCE:
(List your last 5 jobs, beginning with your current employment)
NAME AND ADDRESS OF EMPLOYER

TITLE/TYPE OF WORK

DATES (Month and year)

From
To

13. HAVE YOU EVER PARTICIPATED IN A U.S. EMBASSY-SPONSORED PROGRAM? IF SO, WHICH PROGRAM, AND
WHEN?

14. LIST SCHOLARSHIPS OR FELLOWSHIPS HELD AT PRESENT OR IN THE PAST (Give source or sponsor, amount,
where held, and duration.)

15. PLEASE INDICATE ANY OF THE FOLLOWING LEADERSHIP ACTIVITIES YOU HAVE PARTICIPATED IN AND
PROVIDE A VERY BRIEF EXPLANATION:
I have taken leadership courses or training YES/NO

I have been involved in an action-oriented volunteer group (including student associations, community service clubs, social
activism groups, protest movements, etc.) YES/NO

I have been involved in efforts to lobby local or national government for policy change YES/NO

I have held a position of leadership in an organization (executive director, deputy director, editor-in-chief, regional/provincial
manager, teacher, coach, religious leader, school rector, etc.) YES/NO

I have initiated non-activist social or volunteer group(s) (such as discussion groups, professional associations, alumni
associations, common interest groups, social groups, online forums, etc.) YES/NO

I have founded an action-oriented volunteer group (including student associations, community service clubs, social activism
groups, protest movements, etc.) YES/NO

I have personally lobbied local or national government for policy change YES/NO

I have proposed and implemented reform in my organization YES/NO

I have held public office or run for public office YES/NO

I have founded a business or non-profit organization (created an official institution) YES/NO

Other (Please Explain):

16. PLEASE INDICATE ANY OF THE FOLLOWING VOLUNTEER ACTIVITIES YOU HAVE ENGAGED IN, AND PROVIDE
A VERY BRIEF EXPLANATION:
I am a member of a non-profit/volunteer organization in a paid capacity YES/NO

I have done volunteer work at some time in my life YES/NO

I currently and regularly volunteer my time with a non-profit/volunteer organization YES/NO

I have founded a volunteer or non-profit organization YES/NO

Other (Please Explain):

17. PLEASE INDICATE ANY OF THE FOLLOWING INTELLECTUAL OR ARTISTIC ACTIVITIES YOU HAVE
PARTICIPATED IN AND PROVIDE EXPLANATION:
I have published non-academic works (poetry, fiction stories, opinion pieces, art) YES/NO

I have conducted independent research that did not lead to publication YES/NO

I have written an article for a news agency (once) YES/NO

I have written multiple articles for news agencies (more than once) YES/NO

I have published academic work (once), or released unpublished academic works YES/NO

I have published multiple academic works (more than once) YES/NO

I have worked or volunteered as a teacher, instructor, or professor YES/NO

I have participated or assisted in research or surveys YES/NO

I have led independent research and published the results YES/NO

I have received an honor or fellowship for academic work YES/NO

Other (Please Explain):

18. PLEASE LIST ANY HOBBIES, ATHLETIC, OR INTELLECTUAL INTERESTS YOU PURSUE OUTSIDE OF SCHOOL
AND WORK, AND MENTION IF YOU ARE A MEMBER OF ANY GROUP, ASSOCIATION, OR TEAM OF PEOPLE WITH
THE SAME INTEREST.

19. LIST PROFESSIONAL SOCIETIES, FRATERNITIES OR OTHER ORGANIZATIONS IN WHICH YOU NOW HOLD
MEMBERSHIP OR IN WHICH YOU HAVE BEEN ACTIVE IN THE PAST (Indicate if you have held an elective office.)

20. LIST ANY BOOKS, ARTICLES OR THESES PUBLISHED BY YOU, ESPECIALLY IN YOUR PROPOSED FIELD OF
STUDY (Give title, place and date of publication)

21. RESEARCH: (Including any research you have completed or in which you are currently involved.)

22. INDICATE ANY ACADEMIC HONORS OR PRIZES WHICH YOU HAVE RECEIVED, WITH TITLES AND DATES

23. TEACHING EXPERIENCE: (Including any teaching positions you have held or currently hold.)

24. KNOWLEDGE OF LANGUAGES: (Rate yourself Excellent, Good or Fair Include all languages in which you have some
competence.)
Mother

Tongue
LANGUAGE

READING

WRITING

SPEAKING

English

25. HOW MANY YEARS HAVE YOU STUDIED ENGLISH?

26. ENGLISH TEST SCRORES (TOEFL IBT/PBT or IELTS) Please specify

27. OTHER EXAMINATION DATES AND TEST SCORES: (GRE, GMAT, etc)

28. Please indicate countries outside your own, including the United States, in which you have lived,
traveled, or studied. Please list dates (months/years) and reasons for each visit.
Reason for visit

Country visited

Dates of visit
From (mo/yr)
To ((mo/yr)

1.

2.

3.

4.

5.

6.

29. OTHER SCHOLARSHIPS

A. Are planning to apply for a fellowship, scholarship, assistantship or other educational grant or loan from another
organization, government or educational institution? YES/NO

B. Have you applied for, or received any other scholarships in the past from the U.S. government?

YES/NO

C. If you were not selected for the scholarship, please indicate the year(s) you applied and/or participated:

30. CONTACTS/ASSOCIATES: Do you know anyone else who has applied for a U.S. Embassy-sponsored scholarship or is
applying for a scholarship now? If so, please name the person(s) and which scholarship they applied for or are applying for.
If they have participated in an exchange program, please specify which one, and where the person is now.

31. RECOMMENDATIONS: List the names of a persons from whom you have requested three recommendation letters.
NAME

POSITION

PHONE AND E-MAIL ADDRESS

I.

II.

III.

32. STUDY OBJECTIVES AND FUTURE PLANS

Write a clear and detailed description of your study objectives and give your reasons for wanting to pursue them. Be specific about
your major field and your specialized interests within this field. Describe the kind of program you expect to undertake, and explain
how your study plan fits in with your previous training and your future objectives. This statement is an essential part of your
application. Do not mention specific U.S. universities at which you would like to study. Also, incorporate your future plans with your
study objectives. In your future plans, describe the career you plan to pursue after completion of study in the U.S. (e.g., teaching,
government, business, industry or any plans you might have for continued study or research in your home country). Also indicate if
you will be returning to former employment or if you have been promised a position in your home country after completing your U.S.
training.
NOTE: Please limit your response to the size of this text box of fifty lines of text.

Type your Study Objectives and Future Plans only in this space

33. PERSONAL STATEMENT

This personal statement should be a narrative statement describing how you have achieved your current goals. It should not be a mere
listing of facts. It should include information about your education, practical experience, special interests, and career plans. Describe any
significant factors that have influenced your educational or professional development. Comment on the number of years of practical
experience already completed in the field in which academic work will be done in the U.S. Do not mention specific U.S. universities
at which you would like to study.
NOTE: Please limit your response to the size of this text box of fifty lines of text.

Type your Personal Statement only in this space

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 priority order three schools of your choice. Indicate specific departments and/or
programs. Give specific reasons for each choice. If you have been in contact with professors, please provide names, email,
and/or phone contacts for each one. Your preferences will be taken into consideration insofar as possible.

34. MOST HIGHLY PREFERRED INSTITUTIONS

Please list any other U.S. institutions and departments in which you also may be interested. Feel free to share other
information that you think might be helpful, e.g. preference for a geographic location, climate, etc.
It is not expected that you will apply for admission by direct application or correspondence with a university in the United
States. If, however, you have already submitted an application form directly to any universities in the U.S., list the names
of these institutions below and indicate the response you have received, if any. Please attach letters of admission, letters of
invitation, and deferral requests to your application.
University/Department

Date of Application

Response to Application

35. HOW DID YOU LEARN ABOUT THE FULBRIGHT PROGRAM? (Please indicate all that apply.)
Friend or relative (Specify)
Previous Fulbright participant (Specify)
U.S. Embassy Kabul Website
Poster/Flyer
Other Internet Link (Specify)
University (Specify)
Newspaper (Specify)
Other Publication (Specify)

36. PLEASE LIST ALL THE NAMES, AGES, CURRENT OCCUPATIONS, EMPLOYERS, AND PLACES OF RESIDENCE
FOR YOUR EXTENDED FAMILY MEMBERS. If you are not in contact with certain members of your family, please at least include
their name and the country where they currently live. If you do not include sufficient details in your application, you may be asked to
provide additional information later which can affect your candidacy for Fulbright. This information will be used to ensure that no family
members of a candidate are involved in the selection process.
Example:
Father: Fazil Noor, 58, Mini-Bus Driver, Self-Employed, Kabul, Afghanistan
Mother: Marwah Noor, 55, Homemaker, Kabul, Afghanistan
Wife: Mehria Noor, 23, Homemaker, Kabul, Afghanistan
Husband: N/A (not applicable)
Fianc/Fiance: N/A
Children: N/A
Brothers:
Mohammad Noor, 26, Program Manager, UN Development Program, Kabul, Afghanistan
Fawad Noor, 16, Student, Afghan-Turk High School, Kabul, Afghanistan
Sisters:
Fatima Sediqi, 29, Financial Advisor, Anchor Bank, New York, USA
Homaira Hussain, 25, Homemaker, Parwan Province, Afghanistan
Uncles:
Najibullah Noor, 51, Unemployed, Wardak Province, Afghanistan
Aunts:
Najia Zahidi, 44, Employment Unknown (refugee), Peshawar, Pakistan
1st Cousins:
Afsana Azad, 30, Interpreter, Dyncorp, Kabul, Afghanistan
Nasim Noor, 28, Communications Assistant, Ministry of Interior, Kabul, Afghanistan
Step-Mother: N/A
Step-Father: N/A

Please complete with your family information (use additional space as needed):
Father:

Mother:

Wife:

Husband:

Fianc/Fiance:

Children:

Brothers:

Sisters:

Uncles:

Aunts:

First Cousins (Sons/Daughters of Aunts and Uncles):

Additional Space for Family Member Information:

Children:

Brothers:

Sisters:

Uncles:

Aunts:

1st Cousins (Sons/Daughters of Aunts and Uncles):

Step-mother:

Step-father:

Step-brothers:

Step-sisters:

Half-brothers:

Half-sisters:

______. By checking this box, I certify that all of the information provided in my application and questionnaire is true and complete,
and that if I lie about anything during the application process I may be banned from this government program and will be forever ineligible
to participate in any other U.S. Embassy-sponsored program in Afghanistan. I also understand that if I have committed fraud or
misrepresentation on this application, the U.S. Embassy may inform other scholarship-granting organizations that I have committed fraud.

I understand that my candidacy for this program may be terminated at any time if it is found that I have lied during the
application process or in my correspondence with the U.S. Embassy.