Name: _________________________________________________________________________

Mailing Address: _________________________________________________________________

_______________________________________________________________________________

From date: _________________ to date ________________

Alternative Address: _________________________________________________________________

_______________________________________________________________________________

From date: _________________ to date ________________

Telephone (____) _______________________ [needed for Turkish interview]

Alternate Telephone (____) _____________________

E-mail Address: ________________________________________

U.S. Social Security Number: _____________________________

Please check as appropriate:

[ ] U.S. Citizen

[ ] Permanent Resident

Education: Please list college/university attendance to date and any additional language training undertaken. Please submit an official transcript from your present institution.

Institution || Dept/Major || Degree || Date

_______________________________________________________________________________

_______________________________________________________________________________

_______________________________________________________________________________

Prior Turkish Language Training: Please list all instruction you have had in Turkish, indicating type of instruction (academic, private tutoring, etc.), length of instruction, and skills stressed (reading, oral communication, etc.)

Institution || Type of Instruction || Duration || Language Skills Stressed

_______________________________________________________________________________

_______________________________________________________________________________

_______________________________________________________________________________

In-Country Experience: If you have spent any time in Turkey, please list briefly your reason for going, the duration of your stay, and the degree to which you relied on your ability to use Turkish.

Purpose of Visit || Nature of Activities || Duration || Use of Language

_______________________________________________________________________________

_______________________________________________________________________________

_______________________________________________________________________________

Letters of Reference: Please list the names of three people you have asked to write letters of reference. The letters can be sent together with your application or separately:

Name || Position || Institution || e-mail address

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

Teaching: Are you currently teaching or do you intend to pursue a teaching career?

[ ] Yes [ ] No

If yes, what field? _________________________________________________________

Degree Program: Are you currently enrolled in a M.A. or Ph.D. program?

[ ] Yes [ ] No

If yes, what is your field? ______________________________________________________

Department of Program _________________________________________________

Institution ____________________________________________________________

Anticipated degree and date ______________________________________________

If not, will you be enrolled in a degree program in Fall 2010?

[ ] Yes [ ] No

If yes, what will your field be? __________________________________________________

Department of Program _________________________________________________

Institution ____________________________________________________________

Anticipated degree and date ______________________________________________

Personal Statement: Please state briefly your reasons for applying to the ARIT-AATT program.

Signature of Applicant___________________________________________________

Date: ________________