NAME: | Mariya I. Ivanova | COUNTRY: | Russian Federation |
30. ADDITIONAL INFORMATION Please refer to the instructions from your Fulbright Program Office. It is possible that the Fulbright Program Office in your home country will have specific information that it would like you to include on this page. If the Program Office does not have specific requirements, then in this section you may want to attach a professional resume (usually required for professional degrees such as law and MBA’s) or a complete curriculum vitae (sometimes required for students pursuing theoretical academic fields). NOTE: Please limit your response to the size of this text box of fifty lines of text. | |||
NAME: | Mariya I. iVANOVA | COUNTRY: | Russian Federation | ||||||||||||
PERSONAL INFORMATION | |||||||||||||||
31. CURRENT MAILING ADDRESS | STREET: | 60-letiya Octiabrya Apt #: 13-56 | |||||||||||||
CITY: | Moscow | STATE/PROVINCE: | |||||||||||||
POSTALCODE: | 119618 | COUNTRY: | Russian Federation | ||||||||||||
TELEPHONE :# | +7 495 243 78 80 | WORK PHONE: | +7 495 255 64 19 | ||||||||||||
EMAIL: | mariya@yandex.ru CELL PHONE: +7 916 200 78 89 |
32. NATIONAL IDENTIFICATION # (if applicable):Russian | 33. Marital Status: divorced | 34. Number of Dependents: (spouse and children)1, daughter |
35. PLEASE DESCRIBE ANY PHYSICAL IMPAIRMENT YOU MAY HAVE. (This information is gathered for statistical purposes and to ensure appropriate placement. The Fulbright Program does not discriminate on the basis of race, color, religion, sex, national origin, and/or physical impairment.) N/A |
36. OTHER SCHOLARSHIPS: Indicate if you are planning to apply for a fellowship, scholarship, assistantship or other educational grant or loan from another organization, government or educational institution. (This information will not prejudice your application.) the 43rd Annual TESOL Convention, Denver, USA |
37. REFERENCES: List the names of persons from whom you have requested letters of reference.
NAME | POSITION | E-MAIL ADDRESS | |
I. | Lyudmila S. Chikileva | Professor, Head of Chair of Foreign Languages at All-Russian Distance Learning Institute of Finance and Economics | mila-chikileva7@yandex.ru |
II. | Anna D. Plissetskaia | Ph.D, Head of Foreign Languages Department at Institute of Journalism and Creative Writing | Annaplis21@mail.ru |
III. | Ekaterina A. Belyaeva | Head of Curriculum and Research Department at All-Russian Distance Learning Institute of Finance and Economics, Orel Department | Katyabilya17@rambler.ru |
38. PROPOSED LENGTH OF STAY IN THE U.S 12 months 39. APPROXIMATE ARRIVAL DATE: August-September 2009 |
40. HOW DID YOU LEARN OF THIS FULBRIGHT COMPETITION? (Please indicate all that apply.) Friend or relative University (Specify) Fulbright Website Previous Fulbrighter Newspaper (Specify) Internet Link Poster/Flyer Other Publication (Specify) Other (Specify) |
Application Page 7
NAME OF APPLICANT: | Mariya I.Ivanova | COUNTRY: | Russian Federation |
PERSONAL FINANCIAL INFORMATION FORM |
Because some scholarships provide only for part of the cost of an academic year in the United States, it is necessary to know what portion of the total expenses you and your family can pay from personal funds.
INDICATE ALL FUNDS IN U.S. CURRENCY
41
FUNDS AVAILABLE FOR YOUR FIRST YEAR OF STUDY IN THE UNITED STATES (U.S. Dollars)
(a) Family Funds
1. Father’s occupation:
business
Mother’s occupation: retired
Spouse’s occupation:
Secondary school pupil
2. What is the total amount your family can provide for your FIRST YEAR of study in the U.S.?
b) Your Own Funds
What is the total amount you can provide from your own funds for your FIRST YEAR of study in the U.S.?
$1000
$500
(c) Other Funds
Have you been awarded or do you expect to receive financial assistance from a university or institution in
your home country in the U.S. or from any other sources? Yes No
If so, identify the source and indicate the estimated amount?
Source Estimated Amount
N/A $N/A
N/A $N/A Subtotal of C
N/A $N/A GRAND TOTAL OF A, B, and C
$N/A
$N/A
$N/A
42.
FUNDS AVAILABLE AFTER YOUR FIRST YEAR OF STUDY IN THE UNITED STATES
(a) If you remain for more than a year would the same amount of money as indicated in “GRAND TOTAL” above be available for your SECOND YEAR of study in the U.S.?
Yes No
(b) If “No” please specify the amount that will be available to you the SECOND YEAR:
1. Family Funds:
$0
2. Your Own Funds:
$0
3. Other Funds:
$0
TOTAL of 1, 2 and 3
$0
43.
TRAVEL FUNDS (Do not include funds specified in Sections 41 and 42 above)
(a) Can you pay for your round-trip travel to the U.S. if necessary?
(b) Specify the amount you have available for round-trip travel:
Yes No
$500
44.
DEPENDENTS
The Foreign Fulbright Student program does not provide for depenedents. The Fulbright program cannot be responsible in any way for dependents ACCOMPANYING YOU TO THE U.S. Should dependents accompany you, you will be responsible for providing travel, adequate insurance, and support for them.
(a) List the relationships and ages of any persons who will require financial assistance from you during your stay in the U.S.: None
(b) Will these dependents accompany you to the U.S.?
If “Yes”, state how you intend to provide for them during your year of study in the U.S.:
(b) Will these dependents accompany you to the U.S.?
Yes No
If “Yes”, state how you intend to provide for them during your year of study in the U.S.:N/A
NAME: | MARYA I.IVANOVA | COUNTRY: | Russian Federation |
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. | |||
45. MOST HIGHLY PREFERRED INSTITUTIONS
UNIVERSITY | DEPARTMENT | DEGREE | SPECIALIZATION/ | SPECIFIC REASONS |
1. | ||||
2. | ||||
3. |
46. OTHER INSTITUTIONS IN WHICH YOU MAY BE INTERESTED
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.
47. 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 pf Application | Response to Application | |
N/A | N/A | N/A | |
N/A | N/A | N/A | |
N/A | N/A | N/A |