Professional Documents
Culture Documents
2- Gender
Male
Female
5- Citizenship
6- Country of residence:_Tunis__________________________
7- Contact information
8- Medical, physical, dietary, or other personal considerations: Please describe any pre-existing
medical conditions or disabilities, including any prescription medication you may be taking, or other
dietary/personal considerations. This will not affect the candidate selection process, but will enable the
host institution to make necessary accommodations.
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9- Academic information
Major: __________________________________________
University: __________________________________________
Purpose:____________________________________________________________________
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15- Personal statement: In 250 words or less, please tell us why you are interested in participating in this
program, what you expect to gain from this experience, and what you will contribute to the program. In
addition, your personal statement should provide relevant information on your background, interests,
and/or goals.
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16- Please check this box if you agree to the following statement .
The information in this application is accurate and complete. The written work in the short essays is my
own and I have not been assisted by any other person. I understand that I may be required to verify
information in this application by providing documentation including (but not limited to) transcripts, test
scores, and writing samples. I also understand that intentionally falsifying information in this application will
disqualify me from U.S. government exchange programs.
Date:28/11/2021