2024 Benjamin Franklin Transatlantic Fellowship

Application Form

1. First name:

2. Given Name(s) if on passport:

3. Last name:

4. Gender:

5. Date of Birth: Month/Day/Year

6. City of Birth:

7. Country of Birth:

8. Country of Citizenship:

9. Passport issued?

10. Passport number:

11. Address Line 1:

12. Address line 2:

13. Address City:

14. Address Postal Code:

15. Nominee Telephone Number:

16. Nominee Email Address:

17. High school name:

18. Medical, Dietary, or Personal Considerations:

19. Coursework, Training, Activities:

Please list by:
1. Dates (mm/dd/yyyy)
2. Title of course, scholar contest, training, activity, workshop etc.
3. Institution/NGO that organized the activity
4. One phrase description of the Institution’s/NGO’s mission
5. One phrase description of the candidate’s role/involvement
20. Previous Study or Travel in the United States:
Yes
No

21. If yes, please list any previous travel to the United States for the purposes of
tourism/vacation, educational study, Provide dates/duration, purpose of visit(s), and location.
(Example: July 4-14, 2019 Tourism to Washington, D.C.; December 1-15 2018, Short Term
Study Abroad to New York City, NY.)

22. Evidence of Competence in English:

Cambridge Certificate
Test score
Writing sample
Evaluation of the English teacher with name and contact information

23. Candidate Personal Statement:

As part of the application process, candidates should submit a personal statement about their
background and goals. In up to 500 words, the candidate should address the following questions
and any other pertinent information:

• Why are you interested in participating in the Benjamin Franklin Transatlantic

Fellowship?
• Can you please tell us why you feel that you are well suited for the Institute?
• What makes you unique as a candidate?
• What do you hope to gain from the Benjamin Franklin Transatlantic Fellowship?
• What will you contribute to the Benjamin Franklin Transatlantic Fellowship?
• How will you leverage the experience upon your return to the home country?