Statement of Interest
If you are interested in serving on a 2008 Fulbright Alumni Conference International Organizing Committee, please answer the following questions.  Responses are kindly requested by December 31, 2004. 
If you have any problems using this form, please e-mail .

This form contains three sections (Contact Information, Fulbright Grant Information, and Questions).  Please complete all sections and click the "Submit Statement of Interest" button at the bottom of the page to submit your questionnaire.

Please Note:  Please use the TAB key or your mouse to move between fields.  Pressing the ENTER or RETURN key will cause your form to automatically submit.

CONTACT INFORMATION                           
Title:            *                                       * indicates required field.  If you have no response, please enter "n/a".
First Name:  *
Last Name (Surname):  *
City:  *   State/Province:  *   
Country:
Primary/Preferred E-mail Address:  *
Secondary/Alternate E-mail Address:
Telephone:
Job Title or Current Occupation:
Employer Name:

FULBRIGHT GRANT INFORMATION
First Grant
Host Country:    Year Grant Started:   (yyyy)
Host Institution:
Home Institution:
Type of Grant:
Academic Discipline or Professional Field:

Second Grant
Host Country:    Year Grant Started:   (yyyy)
Host Institution:
Home Institution:
Type of Grant:
Academic Discipline or Professional Field:

Third Grant
Host Country:    Year Grant Started:   (yyyy)
Host Institution:
Home Institution:
Type of Grant:
Academic Discipline or Professional Field:

QUESTIONS
1) Please describe any role(s) you have previously played in your Fulbright alumni association.  For example, have you been involved with a local chapter, attended a conference, planned a conference or event, provided hospitality or helped with events for current grantees, served on the association's board of directors, etc.?  If there is no active alumni association in your country, please describe your Fulbright-related activities since your grant.  For example, serving on review committees, speaking about your Fulbright experience, providing hospitality to visiting grantees, etc.
 *

2) Please briefly describe to the best of your ability the goals and priorities of your country’s Fulbright alumni association.
 *

3) Please describe how your network of relationships/contacts will enable you to obtain funds for the 2008 conference.
 *

4) Please describe how your network of relationships/contacts will promote your efforts to secure funding to support young alumni from your region and alumni from regions without funding to attend the 2008 conference.
 *

5) The 2008 International Organizing Committee will not have funding available to offer financial support to committee members for participating in the committee’s work.  Do you have access to resources to support your involvement with, and participation in, the committee?  (Possible expenses include travel, per diem, telephone calls, materials, etc.)
 *

6) How much time per month can you devote to the planning and organizing of a Fulbright International, Interdisciplinary Conference in 2008?
 *

7) How will your background enable you to successfully implement this project?
 *

8) Please use the space below to include any additional information you think will be useful to the selection process.
 *