Form DS-7646 U.S. National Commission for UNESCO Laura W. Bush Travel

U.S Department of State

U.S. National Commission for UNESCO
Laura W. Bush Traveling Fellowship

OMB APPROVAL NO. 1405-xxxx
EXPIRATION DATE: xxxx
ESTIMATED BURDEN: 10 hours

2008 - Application Coversheet
Step 1: Applicant Information
First Name:

Last Name:

Middle Initial:

College/University Enrolled:
Contact Phone:

Contact Email:
Contact Address:
U.S. Citizen:

Yes

No

Step 2: Proposal Information
Title of Your Proposal:
Brief Title or Description of Your Proposed Program or Project:

Proposed Country(ies) of Travel:
Approximate Dates of Your Proposed Activity:

Checklist for Completed Application Package
Reminder: All materials must be submitted electronically to the U.S. National Commission for UNESCO Executive Secretariat
([email protected])
1) Completed Application Coversheet
2) One page summary of proposal
3) Essay (up to 500 words, double spaced) stating interest in being considered for award
4) Current résumé
5) One page letter of recommendation
I certify that this application is accurate and the materials I am submitting are my own work and complete to the best of my
knowledge.

Signature

Date (mm-dd-yyyy)

PRIVACY ACT STATEMENT
AUTHORITIES: The information is sought pursuant to provisions in 22 USC 287o et seq., and 22 USC 2651a, 2656, 1431 et seq., and 2451 et seq.
PURPOSE: The primary purpose for soliciting the information is to establish the identity of the fellowship applicant and his or her qualifications to undertake the proposed project. The fellowship is
intended to promote international collaborative efforts that build strong foundations of knowledge that bridge nations, encourage freedom, and promote democracy.
ROUTINE USES: The requested information will be collected by the Executive Secretariat of the U.S. National Commission for UNESCO, within the Office of UNESCO Affairs (IO/UNESCO). The
information will be reviewed for the purpose of identifying the most meritorious proposal, as measured against the published evaluation criteria. Information relevant to the vetting of fellowship
applications will be maintained in accordance with Privacy Act provisions.
Failure to provide the information requested on this form will result in an incomplete application, and thus a declaration of ineligibility.
PAPERWORK REDUCTION ACT STATEMENT
Public reporting burden for this collection of information is estimated to average 10 hours per response, including time required for searching existing data sources, gathering the necessary
documentation, providing the information and/or documents required, and reviewing the final collection. You do not have to supply this information unless this collection displays a currently valid OMB
control number. If you have comments on the accuracy of this burden estimate and/or recommendations for reducing it, please send them to: U.S. Department of State, A/ISS/DIR, 1800 G St. NW,
Washington, DC 20520

DS-7646
xx-xxxx