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Application

Spring 2018 YSEALI Academic Fellowship


The YSEALI Academic Fellowship will bring current and recently
graduated students from ASEAN member countries to the U.S. for
five week Institutes at preeminent U.S. universities and colleges.
The Institutes will include an academic residency, leadership development, an
educational study tour, local community service activities, and opportunities to
engage with American peers. All programs will conclude in Washington, D.C.
to allow for networking with policy makers, government representatives,
businesses, and think tanks.

To apply for the YSEALI Academic Fellowship, submit the following


items to YSEALIThailand@state.gov:

 Completed Application (below);

 Current CV (limit 2 pages);

 Two (2) Letters of Recommendation from advisors, professors,


supervisors or community leaders who can speak to your character,
performance, and past experience relating to the YSEALI topic that you
are applying for. Family members and personal friends may not provide
letters of recommendation.

The deadline to apply is 10:00 PM (Thailand Time), 25 October 2017.

We anticipate the final selection will be announced by early December 2017.

Eligibility
Are you a YSEALI member?

Only YSEALI members are eligible to apply for the YSEALI Academic Fellowship
Institutes Program. If you are not yet a member, please sign up now at
http://asean.usmission.gov/yseali.

Note: There is no cost or commitment to become a member.


Yes

No, but I have just signed up at http://asean.usmission.gov/yseali.

Please check all that apply to you. I am:

A citizen of Thailand.

A resident of Thailand (currently studying or living in Thailand).

Between 18-25 years of age.

A full-time undergraduate student from university or other institutions in Thailand.

A recent graduate, having completed an undergraduate degree within the past four
years.

YSEALI Academic Fellowship Institutes Spring 2018 will be hosted at the


following institutes. Please choose your preferred institute.

Note: You can only apply to one Academic Fellows Program during the Spring 2018
application. If it is determined that you have applied to more than one Fellows program
during this application period, your application will be deemed ineligible and your name
will be removed from consideration.

Note: The U.S. Embassy Bangkok will make the final selection and may move
candidates to different themes or institutes.

Kennesaw State University, Civic Engagement (from Jan. 31 – Mar. 11, 2018)

University of Nebraska-Omaha, Civic Engagement (from Mar. 24 – Apr. 28,


2018)

Arizona State University, Civic Engagement (from Mar. 25 – Apr. 29, 2018)

East-West Center-Hawaii, Environmental Issues (from Mar. 14 – Apr. 18, 2018)


University of Connecticut, Social Entrepreneurship and Economic
Development (from Mar. 17 – Apr. 20, 2018)

Arizona State University, Social Entrepreneurship and Economic


Development (from Mar. 25 – Apr. 29, 2018)

Directions
To apply for the YSEALI Academic Fellowship, submit the following items to
YSEALIThailand@state.gov before 10pm (Thailand time) 25 October 2017:

 Completed application

 Current CV (limit 2 pages)

 Two (2) Letters of Recommendation

Personal Information
This information below must match your passport or other government-
issued ID.

Surname (family name) *


Given Names *

Contact Information
Primary Telephone
(Include country code) *

Other Telephone
(include country code) *

E-mail Address *
Re-type E-mail Address *
Biographical Information
What is your native language?

Please rate your English language proficiency on a scale from 1-5, with 5 being able to
deliver high level academic or professional presentations to native English-speaking
audiences. *

Gender *

Female

Male

Date of Birth
month, day, year (Example: June 1, 1995) *
City/Town of Birth *
State/Province of Birth *
Country of Birth *
Country of Citizenship *

Do you have any dietary restrictions? *

No

Yes (please list)


Do you have any physical conditions or allergies about which we need to be
aware to prepare for your participation in the Summit? *

No

Yes (please list)

Have you participated in any other YSEALI activities? *

No

Yes (please list)

Current Contact Address


Street Address *
Street Address #2 (If applicable)
City/Town *
Country *
Postal Code *
Telephone (including country code) *
Skype ID
Facebook Account
Twitter Account
Home Address
(if different from current address)
Street Address
Street Address #2 (If applicable)
City/Town
Country
Postal Code

Educational Experience
Current or Most Recent Education Experience

School or University Name *


Dates Attended (Format MM/YY) *
City *
Country *
Current Year in University *
Field of Study *

Do you use English in your professional or academic settings? *

No

Yes (Please describe)

Graduation Year (or estimate)*

2012 2017

2013 2018

2014 2019

2015 2020
2016 other:

Current Employer
(including full-time or part-time employment, and/or paid internship)

Current Employer Name *


Dates of Employment (Format MM/YY) *

Position Title *
City *
Country *
Website

Volunteer or community service experience


Name of organization/community in which you have performed volunteer or community service

When did you join this volunteer or community service activity? (MM/YYYY)

Memberships in Associations, Clubs, etc. Please include dates. (MM/YYYY)


Please list any additional information about activities, organizations, or jobs you would like to share
that is not evident from your CV.

International Experience
Do you have any previous non-YSEALI-related experience working or studying in the
U.S.? *

No

Yes

If you answered yes, please provide information about your previous U.S. travel,
including purposes and dates (MM/YYYY).

Please indicate the other areas of the world you have visited:

Africa ASEAN (outside your home country)

Australia Asia (Other)

Eastern Europe Middle East


North America South America

Western Europe Not applicable

If you have traveled outside of your home country, indicate the purpose of travel:

Study Visit family members

Leisure/tourism Volunteer activity

Work experience other:

Please list any additional information about any activities or other networking opportunities you
would like to explore during the YSEALI Academic Fellowship in the U.S.

Emergency Contact Information


Give the name and contact information of a spouse, relative and/or close friend which
U.S. Embassy staff can contact in case of an emergency.

Title *
Surname (family name) *
Given Name(s) *
Relationship to You *
Street Address *
Street Address #2 (If applicable)
City/Town *
Country *
Postal Code *

Primary Telephone
(Include country code) *
Secondary Telephone
(Include country code) *

E-mail address *
Re-type E-mail address *

Essays
Please answer the following three essay questions in 250 words or less each*:

1. How do you expect your participation in the Fellowship will affect your
community, country, or the ASEAN region? (250 words or less)

2. Please provide a short biographic paragraph that can be used on the program
website to tell others about you in the event that you are selected to participate
in the program. (250 words or less)

3. Successful applicants demonstrate a commitment to return to Thailand to apply


leadership skills and training gained from the Fellowship in order to benefit their
communities, country, and/or the ASEAN region. Please explain what activities,
services, or programs you would like to implement in the future, and how these
will benefit your community, Thailand, and/or the ASEAN region. (250 words or
less)

* Indicates a required field


Program Terms and Conditions
If you have any questions about the application process or program terms
and conditions, please contact U.S. Embassy
Bangkok at YSEALIThailand@state.gov.

Read and check each statement below to indicate agreement.

As a participant in the YSEALI Academic Fellowship Institutes, I hereby agree


to the following terms and conditions: *
I release the U.S. Embassy and the U.S. Department of State to use any
photographs and written statements for program promotion, published advertising and
other marketing purposes.

I understand that the grant will cover the cost of travel to the U.S. for the YSEALI
Academic Fellowship Institutes. In addition, I understand shared lodging will be covered
as well as most meals.

I certify that I will comply with all laws, regulations and/or restrictions of
appropriate government agencies in the U.S. and will have to comply with the U.S.
Department of State' participant Code of Conduct upon my selection into this program.

I certify that the information given in this form is complete and true and that I will
fulfill my obligations and responsibilities as stated.

Directions
To apply for the YSEALI Academic Fellowship, submit the following items to
YSEALIThailand@state.gov before 10pm (Thailand time) 25 October 2017:

 Completed application
 Current CV (limit 2 pages)
 Two (2) Letters of Recommendation

Technical details:
 Applications can be submitted in either Microsoft Word or .pdf format
 Use the subject line “YSEALI Application Spring 2018_Your Full Name.”
 Submission via email will automatically log the date and time an application
submission is made, and the U.S. Embassy will use this information to determine
whether an application has been submitted on time. Late applications will neither
be reviewed nor considered.