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时间:2019-02-26
《application - vsuru:应用vsuru》由会员上传分享,免费在线阅读,更多相关内容在应用文档-天天文库。
1、PleasePrintLASTNAMEFIRSTNAMEProposedCASEAffiliationCarnegieResearchFellowshipProgramAPPLICATIONAProgramoftheNationalCouncilforEurasianandEastEuropeanResearch(NCEEER)InconjunctionwiththeAmericanCouncilsforInternationalEducation:ACTR/ACCELSSupportedWithaGrantfromCarn
2、egieCorporationofNewYorkThisapplicationmustbecompletedinEnglish,exceptwherespecified.Applicationsshouldbetypewrittenwheneverpossible,otherwisepleasePRINTlegibly,inblackink.ApplicationsmustbesubmittedbyApril30th,2008totheACTR/NCEEERMoscowOffice:PleasePrintLASTNAMEFI
3、RSTNAMEProposedCASEAffiliationAmericanCouncils/NCEEERLeninskiiProspekt,dom2,kom.526a/ya1Moscow119049,RussiaАмериканскиеСоветыпомеждународномуобразованию/NCEEERЛенинскийпроспект,дом2,ком.526А/я1119049Москваtel:(495)647-9839fax:(495)956-7806e-mail:alexei@nceeer.orgww
4、w.nceeer.orgPleasePrintLASTNAMEFIRSTNAMEProposedCASEAffiliationTHISAPPLICATIONMAYBEDUPLICATEDANDISFREEOFCHARGE.1.NAMEPleaseprintyournameinLatinletters(asitappearsonyourinternationalpassportifyouhaveone).Donottranslate(i.e.,writeYuriiPetrovich,notGeorgePeter).______
5、______________________________________________________________________________________________LastNameFirstNamePatronymic2.GENDER(pleasecircleone):MaleFemale3.CITIZENSHIP___________________________________(DonotlistUSSR)Attachrecentphoto4.AGE_______5.DATEOFBIRTH___
6、__/______/________MonthDayYear6.PLACEOFBIRTHcity:_____________________country:___________________PleasePrintLASTNAMEFIRSTNAMEProposedCASEAffiliation7.MAILINGADDRESS(theaddressatwhichyoureceiveyourmail)_____________________________________________________________
7、_______________________________________CountryCityPostalIndex____________________________________________________________________________________________________StreetNameDomKorpusKvartira(_________)__________________________________________________________________
8、_________CitycodeTelephone(home)AnothercontacttelephoneE-mailaddress8.maritalstatus(pleasecircleone)MarriedSingleWidowedDivorced9.children(please
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