LDF Fellowship

A fellowship sponsored by the U.S. Department of State’s U.S.-Middle East Partnership Initiative (MEPI)

PROFESSIONAL REFERENCE FORM

The LDF Fellowship engages emerging leaders across sectors in the Middle East and North Africa in
identifying innovative ways to address social and economic challenges in their local communities. The LDF
Fellowship advances participants’ civic engagement and social entrepreneurship by providing advanced
technical skills, financial and professional resources, and regional support networks.
The LDF Fellowship has five stages that take place over 12 months, including two in-person engagements,
if circumstances allow, and three virtual stages for utilization, adaptation, implementation, and reflection.
The LDF Fellowship is built around the idea that for every skill built there is an application point, and
combines theoretical and practical elements focus on leadership, civic engagement, social
entrepreneurship, system analysis, partnership building, and social inclusion, among other subjects. The
LDF Fellowship consists of an English Track (for high-proficiency English speakers) and an Arabic track (for
high-proficiency Arabic speakers). For more information, please click here.

Professional Reference Form Instructions:

If chosen, this applicant will be involved in an intensive leadership development fellowship and work
closely with other emerging leaders from the MENA region in a learning environment that requires cross-
cultural adjustment and an extended period of teamwork. To be considered eligible, the applicant must
have a minimum of five years of civic engagement or social entrepreneurship experience. Therefore,
kindly be very honest in your assessment of the applicant to help us select the candidates who best fit this
fellowship. The LDF Fellowship is seeking applicants who are:
• Engaged Doers. They have a track record of substantive and meaningful civic engagement or
social entrepreneurship experience, can identify at least one active civic engagement or social
entrepreneurship project that they will focus on throughout the fellowship, and have the
authority, ability, and support to immediately apply what they acquire during the fellowship to
their project.
• Inclusive Leaders. They demonstrate that they have an inclusive mindset and possess relevant
qualities such as humility, awareness of bias, curiosity about others, an authentic commitment to
diversity, being open to alternative ideas and perspectives, and a passion to give back to the
community.
• Inquisitive. They seek personal growth, pursue opportunities for personal and professional
enrichment actively, and demonstrate the ability to think critically, contextualize acquired
knowledge in real-world applications, and transform lessons learned into tangible actions.
• Mission-Driven Collaborators. They already have pursued or are open to pursuing partnerships
within local communities and can collaborate effectively across sectors, driven by a mission to
achieve a positive impact.
I. PROFESSIONAL REFERENCE INFORMATION:

Referee Full Name: Luai Ahmed Al-Bourgi

Telephone Number: +96777392408

Email Address: loaiahmedsultan@gmail.com

Employer: Alam Plastic

Job Title: FM

How long have you known the applicant?

More than 6 years

In what capacity have you known the applicant? Please describe how you have interacted with the
applicant in a civic engagement or a social entrepreneurship setting, including your most recent
engagement with the applicant.

He is a great leader and I believe he will be one of my country's Social influencers

II. APPLICANT RANKING: PLEASE RATE THE CANDIDATE’S QUALITIES IN THE AREAS BELOW.
Please indicate your estimate of the following characteristics in terms of how they pertain to the applicant
by marking an “X” in the appropriate box.

Very Cannot
Applicant Quality Excellent Good Average Poor
Poor Assess

Leads, guides, and inspires others to enact

x
positive change.

Engages actively civic in engagement or

x
social entrepreneurship projects.

Ability to apply lessons learned from the

x
fellowship in their work.

Inclusive mindset traits, such as humility,

awareness of bias, curiosity about
x
others, and authentic commitment
to diversity.

Open to alternative ideas and

x
perspectives.

Passionate to give back to the community. x

Seeks constant learning, self-

improvement, and professional x
enrichment.

Ability to think critically. x

Strategic-minded and have a good

understanding of the community and x
system he/she are seeking to impact

Ability to set specific, measurable,

x
achievable, realistic, and timely objectives.

Ability to effectively perform multiple

x
tasks and activities simultaneously.

Brings together diverse groups to achieve

x
a common goal.
III. SHORT-ANSWER QUESTIONS: PLEASE PRINT YOUR RESPONSES TO THE QUESTIONS BELOW.
What are the applicant’s strengths?

Honesty and self-motivated Person, creatively

What qualities do you recommend the applicant improve upon?

What challenges do you think the applicant might face while participating in this fellowship?

In your opinion, can the applicant immediately apply the knowledge and skills gained during the 12-
month LDF Fellowship? Does he\she have the authority, ability, or support to apply lessons learned in
their civic engagement and social entrepreneurship activities? If yes, how so?

Please comment on the applicant’s overall suitability for the fellowship, specifically their civic leadership
or social entrepreneurship potential and ability to work and collaborate with others.

Signature __________________________________ Date (dd/mm/yyyy) __04/01/2023___________