Foreign Fulbright Program: Page 1 of 13

FULBRIGHT STUDENT PROGRAM

APPLICATION FOR STUDY IN THE UNITED STATES
GENERAL INFORMATION
1. NAME: (As it appears or will appear on your passport.)
Salutation Mr.

Family MUREKASHUNGWE

First

Middle

2. NAME ON PREVIOUS ACADEMIC RECORDS: (If different from above.)

Family MUREKASHUNGWE

First EVERGISTE

Middle

Do not complete shaded area. For Fulbright Program use only.

3. CURRENT MAILING ADDRESS: Institute of International Education
University Placement Services Division
809 United Nations Plaza
New York, NY 10017-3580

4. PERMANENT MAILING ADDRESS:

Street 87 KN 2Av

City NYARUGENGE-KIGALI
 State (if United States)

State/Province (outside United States) KIGALI

Postal Code 726

Country

5. DATE OF BIRTH: July / 14 /

Month Day Year

6. GENDER: Male

7. BIRTHPLACE:
City NYAMASHEKE

State (if United States)

State/Province (outside United States) WEST

Country Rw anda

8. COUNTRY OF CITIZENSHIP:

9. COUNTRY OF RESIDENCE: Rw anda

10. DO YOU NOW HAVE, OR HAVE YOU EVER HELD:

U.S. CITIZENSHIP? No

U.S. DUAL CITIZENSHIP? No

U.S. PERMANENT RESIDENCY? No

STUDY PLANS
11. WHICH APPLICATION CYCLE ARE YOU 2016-2017
APPLYING TO?
DEGREE OBJECTIVE: Nondegree
 12. WHAT IS YOUR PROPOSED MAJOR FIELD Engineering
OF STUDY?
WHAT IS YOUR Agricultural Engineering Agricultural Engin
SPECIALIZATION/SUBFIELD OF STUDY?
Find Specialization/Sub-Field Clear
BRIEFLY DESCRIBE THE SPECIFIC AREA OF THE FIELD IN WHICH YOU PLAN TO SPECIALIZE.
NOTE: Please limit your response to the size of this text box or five lines of text. Anything over this size will not
display or print on your submitted application. Click the "Preview" button at the top of the page to verify that
your response will fit.
My first choice as area of the field of specialization is the Design of irrigation
structures. Having done Civil Engineering during my Undergraduate studies and Masters
of Science in Water Resources and Environmental Management w ith a Major in Irrigation
structures, This specialization w ould make me w ell equipped in finding solution to
problems that people are facing in this domain.

13. FUTURE PLANS: (Describe the career you plan to pursue after completion of study or research 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 or five lines of text. Anything over this size will not
display or print on your submitted application. Click the "Preview" button at the top of the page to verify that
your response will fit.
After the completion of my studies, my first plan w ill be to comeback in my home
country to continue my teaching job and to share my students the new know ledge and
skills acquired during the formation. I plan also to participate actively in conferences
giving strong ideas on the proper design and implementation of the irrigation structures.

Foreign Fulbright Program: Page 2 of 13

EDUCATION
14. LIST EDUCATIONAL INSTITUTIONS ATTENDED IN REVERSE CHRONOLOGICAL ORDER, INCLUDING ANY IN
WHICH YOU MAY BE PRESENTLY ENROLLED.
(List in reverse order. Write name in full. Do not abbreviate)
INSTITUTION

LOCATION

MAJOR FIELD OF STUDY

DATES From
(If you are currently enrolled, please leave the "To - /
Month/Year" fields blank.)
To
/
ACTUAL NAME OF DEGREE OR DIPLOMA
(Do not translate)
DATE RECEIVED OR EXPECTED /
Month Year

INSTITUTION

LOCATION

MAJOR FIELD OF STUDY

DATES From
/
To
/
ACTUAL NAME OF DEGREE OR DIPLOMA
(Do not translate)
DATE RECEIVED OR EXPECTED /
Month Year

INSTITUTION

LOCATION

MAJOR FIELD OF STUDY

DATES From
/
To
/
ACTUAL NAME OF DEGREE OR DIPLOMA
(Do not translate)
DATE RECEIVED OR EXPECTED /
Month Year

INSTITUTION

LOCATION

MAJOR FIELD OF STUDY

DATES From
/
To
/
ACTUAL NAME OF DEGREE OR DIPLOMA
(Do not translate)
DATE RECEIVED OR EXPECTED /
Month Year

INSTITUTION

LOCATION

MAJOR FIELD OF STUDY

DATES From
/
To
/
ACTUAL NAME OF DEGREE OR DIPLOMA
(Do not translate)
 DATE RECEIVED OR EXPECTED /
Month Year

15. LIST SCHOLARSHIPS OR FELLOWSHIPS HELD AT PRESENT OR IN THE PAST (Give source or sponsor, amount,
where held, and duration.)
NOTE: Please limit your response to the size of this text box or five lines of text. Anything over this size will not
display or print on your submitted application. Click the "Preview" button at the top of the page to verify that
your response will fit.

16. INDICATE ANY ACADEMIC HONORS OR PRIZES WHICH YOU HAVE RECEIVED, WITH TITLES AND DATES.
NOTE: Please limit your response to the size of this text box or five lines of text. Anything over this size will not
display or print on your submitted application. Click the "Preview" button at the top of the page to verify that
your response will fit.

17. LIST ANY BOOKS, ARTICLES OR THESES PUBLISHED BY YOU, ESPECIALLY IN YOUR PROPOSED FIELD OF
STUDY. IF POSTED ONLINE, PLEASE PROVIDE US WITH THE URL/WEBSITE ADDRESS.(Give title, place and date
of publication.)
NOTE: Please limit your response to the size of this text box or five lines of text. Anything over this size will not
display or print on your submitted application. Click the "Preview" button at the top of the page to verify that
your response will fit.
18. 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.)
NOTE: Please limit your response to the size of this text box or five lines of text. Anything over this size will not
display or print on your submitted application. Click the "Preview" button at the top of the page to verify that
your response will fit.

19. TEACHING EXPERIENCE: (Include any teaching positions you have held or currently hold.)
NOTE: Please limit your response to the size of this text box or five lines of text. Anything over this size will not
display or print on your submitted application. Click the "Preview" button at the top of the page to verify that
your response will fit.

20. RESEARCH: (Include any research you have completed or in which you are currently involved.)
NOTE: Please limit your response to the size of this text box or five lines of text. Anything over this size will not
display or print on your submitted application. Click the "Preview" button at the top of the page to verify that
your response will fit.