6587.formulario de aplicacion 2014 2015

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APPLICATION FOR ADMISSION TO THE

HUBERT H. HUMPHREY FELLOWSHIP PROGRAM- 2014-2015

FOR MID-CAREER PROFESSIONAL DEVELOPMENT IN THE UNITED STATES

Program Information and Application Guidelines

PROGRAM DESCRIPTION: The Humphrey Fellowship Program provides mid career professionals from designated

countries around the world with an opportunity to enhance their professional capabilities through participation in

specialized, 10 month, and non degree programs developed specifically for small clusters of Humphrey Fellows atselected U.S. universities. The Humphrey Program was initiated in 1978 to honor the memory and accomplishments of

the late Senator and Vice President, Hubert H. Humphrey. Fellows are selected based on their potential for national

leadership and commitment to public service, in either the public or private sector. The program provides a basis for

establishing long lasting productive partnerships and relationships between citizens of the United States and their

professional counterparts in other countries, fostering an exchange of knowledge and mutual understanding throughout

the world.

Funding for the Humphrey Program is provided by the U.S. Government through the United States Department of State

and other co sponsors. The Institute of International Education (IIE) collaborates with the State Department's Bureau of

Educational and Cultural Affairs in administering the program. The types of university programs arranged for Humphrey

Fellows depart from a traditional discipline oriented focus and have a problem solving and experience sharing emphasis.

The programs are not degree related or aimed at providing scholarly preparation or basic training in a field. Theobjective is to provide Humphrey Fellows with an overall experience that broadens their perspectives, enhances their

capability to assume greater career responsibilities, and provides opportunities to establish useful professional contacts.

To accomplish these objectives, programs are designed to include various combinations of course work, independent

projects, internships, consultations with U.S. faculty or experts, field trips, and special seminars. Under the guidance of a

designated faculty advisor or coordinator, Fellows plan programs that best suit their individual career development

needs.

DURATION OF GRANT: The program arranged for Humphrey Fellows extends from August or early September to the

following June. Applicants who need additional English training may be required to arrive in the United States as early as

April for intensive language study before beginning their regular university program. Candidates must be able to

participate in the full period of the English and/or university programs.

NONDEGREE STATUS: The program designed for Humphrey Fellows does not result in the awarding of a degree.

While Fellows are able to enroll in courses relevant to their professional interests, the Humphrey Program is not

appropriate for those who wish to concentrate on academic work required for a U.S. degree. Humphrey Fellows

spend a considerable portion of their time engaged in off-campus activities such as internships, field trips,

workshops, and special projects that give them practical experience in their professional fields. Fellows who

successfully complete the program are awarded a Certificate of Participation.

FINANCIAL PROVISIONS: The Humphrey Fellowship provides a monthly maintenance allowance, a book and supplies

allowance, tuition and fees when applicable, round-trip international travel to the host institution (and to the

Fellows English-language training program when applicable) and domestic travel to Washington, D.C. for a special

seminar. Supplementary funds are provided for professional activities such as field trips or attendance atconferences. Humphrey Fellowships are not renewable.

Humphrey Fellows should plan to bring with them some personal funds to cover incidental expenses not covered in the

grant. Humphrey Fellowships do not include funds for dependents (family members). Humphrey Fellows are

responsible for providing travel, insurance, and financial support for any dependents accompanying them in the United

States. Please note that English and orientation centers cannot accommodate dependents. Therefore, dependents should

not arrive in the United States until the Fellows are settled in their academic year programs and have secured housing


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(at least 30 days after the Fellows arrival) at the host campus.

PROGRAM FIELDS: The programs arranged for Humphrey Fellows are related to one of the following fields:

agricultural and rural development; communications/journalism; economic development; finance and banking;

educational administration, planning and policy; HIV/AIDS policy and prevention; human resource management; law

and human rights; natural resources, environmental policy, and climate change; public health policy and

management; public policy analysis and public administration; substance abuse education, treatment and

prevention; teaching of English as a foreign language (curricular development / teacher training); technology policy

and management; trafficking in persons, policy and prevention; urban and regional planning; higher education

administration. The university programs do not address themselves to the scientific or technical aspects of these

fields, but rather to broad policy-making and problem-solving issues.

PLACEMENT IN UNIVERSITY PROGRAMS: Candidates who are selected for fellowships are placed in clusters by field

of interest at U.S. universities specially designated to host a group of Humphrey Fellows. IIE, therefore, is not able to

make placements at specific universities requested by candidates, or to award fellowships enabling candidates to

attend a U.S. university on the basis that they have already been admitted. Candidates should not apply directly to

U.S. institutions.

APPLICATION GUIDELINES:

1.Each page of the enclosed application carries its own instructions and should be read carefully before

proceeding. This form must be completed in English use a type writer or computer. Please answer everyquestion as completely as possible (except for the Substance Abuse form, page 5A of the application, which

should only be completed by candidates in the field of substance abuse).

2.Please take special notice of #13: in which the question reads "Give a 50-word summary of your proposed

program plan." Please be sure to provide a succinct but substantive summary statement.

3.The completed application must be returned to the Fulbright Commission in Ecuador, Diego de Almagro N25-

41 y Av. Colon, Quito, Ecuador

4. You must attach complete and certified academic documents covering your entire period of study at

universities or other postsecondary institutions, including advanced degrees. You dont need to submit

translations of these documents with your application. Your academic documents must consist of: A certified official record (transcript) from each university or other postsecondary institution, listing the

subjects you studied and the grades (marks) you received during each year of your enrollment. Include all

postsecondary institutions you attended, even those from which you did not receive a degree or diploma.

Certified, official evidence of each postsecondary or university degree, diploma, or certificate awarded to

you.

To be considered official, each academic document must bear the seal of the issuing institution as well as the

signature of its officials. Copies of original documents will be accepted only if they are separately certified as

being authentic duplicates of originals.

5.You are required to submit two letters of reference, one of which must be from your immediate supervisor

in your current position. For the first stage of the process, the letters of reference can be written in

Spanish.

6. Important information about TOEFL:A preliminary TOEFL test will be available for applicants. If you are

applying to the program and have not taken the official TOEFL test, you should register by or before June

21st

, 2013 at the Fulbright Commission in Ecuador to take the exam on Saturday June 29th 2012. For

information and registration to the preliminary TOEFL test, write [email protected].
mailto:[email protected]:[email protected]:[email protected]:[email protected]


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Bio-Sheet A1. NAME OF APPLICANT (Exactly as on your passport/ travel documents) : 4. GENDER: Female Male

Ms.

(Title)

SolangeFirst name

Elizabeth GuerreroLast name

5. PLACE OF BIRTH (city or town,

country): Esmraldas, Esmeraldas,

2. PERMANENT ADDRESS OF APPLICANT:

Valle San Rafael,Voluntad de Dios

Telephone number (include country & city codes): Home: ,(593)+981923017

Work: Fax:

6. DATE OFBIRTH

Month Day Year

dec 21st 1984

7. COUNTRY OF PRESENT

CITIZENSHIP: Ecuador

3. POSTAL ADDRESS OF APPLICANT (If same as above, write same)

Valle San Rafael,Voluntad de Dios

8. COUNTRY OF PRESENT

RESIDENCE: Ecuador

9. HAVE YOU HAD A FULBRIGHT

GRANT IN THE PAST?No

10. EDUCATION: List all post-secondary educational institutions attended, beginning with the most recent, including any inwhich you are currently enrolled. Copies of diplomas, academic transcripts, certificates, should be attached. (To add moreinformation, please copy table onto an additional sheet.)

Name of institution,university or

professional school,and location

Major field(s)of study

Dates attended (month and year) Actual name ofdiploma or degree (do

not translate)

Date received orexpected

From To

1. Instituto deBachillerato "5 deAgosto"

Quimico-Biologicas

1996 2002

Bachiller enciencias,especializacionQuimico-biologicas

January 26th2002

2. PontificiaUniversidadCatlica delEcuador sedeEsmeraldas

AppliedLinguisticsTeachingof English

2008 2012

AppliedLInguistics:Teaching ofEnglish

June 2013

3.

4.

11. Name yourmost significant publications/honors/awards/projects/other accomplishments. Please limit your response to 250words or less:

I got recognition when I was studying in the university, which was to get good scores during a semester.

Even I did not receive the same recognition in next semesters I kept good scores during the career.Nowadays, I am working on my thesis degree, this one includes a proposal in order to improve theeducational system of this school (Applied Linguistics School) such as methodology, virtual library andexchange opportunities for undergraduates and so on, which will help students to get a quality educationand be trained successfully to give an excellent service in their communities.


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12: FIELD OF STUDY: Applied Linguistics: Teaching of English13. GIVE A 50-WORD SUMMARY OF YOUR PROPOSED PROGRAM PLAN (a more detailed plan to be described in question21).

1.-Learn about methodology for teaching English in the seminars.2.- Apply in real class methodologies by giving service in schools or English courses3.-Write reports or a thesis research about how methodologies work out

4. Plan as art of the research to do worksho s addressed to teachers in m countr .14. CURRENT OCCUPATION:

Organization: Unidad Educativa Liceo Naval "Calm. Ramon CAstro Ji on"

Your job title: Teacher

Dates of employment (month & year): from A ril 1st 2009

Name and address of your place ofemployment:

Ciudadela Naval

15. Describe your current job responsibilities. Please limit your response to 250 words or less.:

I am working as a teacher for kids from third and fourth grade at the Elementary school, a military school.I teach Basic English and it is a blessing to teach to them because they learn fast. We learn songs and easychants to get vocabulary and we practice phrase they can apply every day.

Bio-Sheet B16. Previous positions held (begin with most recent):

Name & address of place of employment Job Title

Dates of Employment

From (in years) To

1. Unidad Educativa Liceo Naval "Calm. RamnCAstro Jijn"

English Teacher 2009 2013

2.

3.

4.

5.

17. On a scale from 1-5, please indicate your computer proficiency level in the following areas:

Word Processing: 4 Email: 5 Spreadsheets: 3

18. Please indicate countries outside your own, including the United States, in which you have lived, traveled, or studied. Pleaselist dates (months/years) and reasons for each visit. If your travel history exceeds the space provided in the application, please

attach an additional sheet with your travel information.

Country visited Reason for visit (study, work, tourism, conference)

Dates of visit

From (mo/yr) To ((mo/yr)

1. Colombia Missionay Training Center ( few days) Jan 2006 Jan 2006

2.


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3.

4.

5.

6.

19. Persons to be notified in case of emergency:

In home countr : In the United States friend or famil member :

Name: Sonia Rodri uez Name: Mara de los An eles Rodri uez

Address: Valle San Rafael , Voluntad de Dios Address: New Jersy

Telephone: 593 +994552037 / 2 461-005 Telephone: 19733936876Relationship Mother Relationship: Aunt

I certify that all information given in this application is complete and accurate to the best of my knowledge. I acknowledge that Ihave completely read and understood the Information and Application Instructions and I agree to comply with all regulationsdescribed there. I agree to abide by the Policies governing the selection of Fulbright/Humphrey grantees, as established by the J.William Fulbright Foreign Scholarship Board (FSB) (complete policies available at http://eca.state.gov/fulbright/about-fulbright/j-william-fulbright-foreign-scholarship-board-ffsb/ffsb-policies). I understand that final approval of myapplication is dependent upon my eligibility for a J Visa in the United States. I also agree to return to my home country

upon the expiration of my authorized stay in the United States.

Signature: ___________________________________________________ Date: _ __

(You must sign here in INK)

Program Plan20. Please describe your major area of interest and explain how this area addresses the specific development needs of yourcountry. Please limit your response to 200-250 words.

I would like to learn about more teaching techniques and new methodology to teach effectively.I am worried about the two skills where we have some challenges in our community; I mean listening and

speaking skills. Obviously, they are so important for communication but we need to help students todevelop those skills for that reason (communication), it is just not about teaching and learning grammar.Challenges in those skills are so evident. It is right that living in a country where students are involved withpeople that speak their mother tongue, which means, when they are out classroom they listen and speak justSpanish that does not help them. The reality in the city of Esmeraldas is different from Guayaquil, Quitoand Cuenca that are considered big cities. Most of the students do not have the opportunity to keep in touchwith native speakers so they cannot to practice a lot what they learn in the classroom and apply it for realsituations and I am sure there are solutions for those problems.

Also, some teachers do not use updated methodology and according students needs and interests in orderto help them to love English, I would like to know effective, interesting and innovative methodology forhelping student to develop and improve listening and speaking skills.
http://eca.state.gov/fulbright/about-fulbright/j-william-fulbright-foreign-scholarship-board-ffsb/ffsb-policieshttp://eca.state.gov/fulbright/about-fulbright/j-william-fulbright-foreign-scholarship-board-ffsb/ffsb-policieshttp://eca.state.gov/fulbright/about-fulbright/j-william-fulbright-foreign-scholarship-board-ffsb/ffsb-policieshttp://eca.state.gov/fulbright/about-fulbright/j-william-fulbright-foreign-scholarship-board-ffsb/ffsb-policieshttp://eca.state.gov/fulbright/about-fulbright/j-william-fulbright-foreign-scholarship-board-ffsb/ffsb-policies


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21. Describe the type of Humphrey program you would like to design. Indicate the kinds of academic and professionalexperiences you would like to pursue. Please limit your response to 200-250 words.

I would like all referent to Teaching English as a foreign language. I would like to be trained by specialistin techniques, updated methodology, how to plan according students needs, interests, age and all related toteaching. Also practice in elementary schools or high schools that I will learn from the seminars.

22. Describe how the knowledge and skills you will gain will help you address your country's development needs. Please limityour response to 200-250 words.

By planning and developing workshops teachers will learn updated methodology and different ways ofencouraging students to learn English and also how to plan correctly. They will be practice in real situationsnot just in the seminar and they will be trained frequently to know how applying what they have learnt have

help their students.Creating English club for teacher will help them to speak English because that is another problem, someteachers teach English but they do not speak it.


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Personal Statements AWrite a paragraph answering each of the following three questions. Please use only the space provided

23. Please describe how you have demonstrated a strong commitment to public service. (i.e. community, civic involvement orprofessional responsibilities, etc.) Please limit your response to 200-250 words.

I like to serve to others. I was missionary for the Church of Jesus Christ of Latter-Day Saints for 18 monthwhere I worked without receiving any compensation for it. I am still working with teenagers and children

because I love to serve others and I know how important is to help people to develop and increase theirpotential.I work as a teacher for years and it is interesting how students trust in you even parents because as teacherswe are considered as a guide for them inside and outside the classroom.

I have worked with them (my students) even out classroom without earning for that service but it has beenso gratifying because you can notice and understand how important they are for you and you worried abouttheir progress.

24. Please state your professional goals for the next five years. How will the Humphrey Program help you reachthese goals? Please limit your response to 200-250 words.

My goal for the next 5 years is to work in my country specifically in my city because it needs professional

teachers not only that know how to speak English, also that know how to motivate students for learningEnglish, how to help them to love English language.I would like to create a center for teachers for training them to know about how to teach English as aForeign Language and in this way they could be in a habitually training.

I am sure Humphrey program will help to strength my skills, update my knowledge about teaching , tolearn new, motivating , interesting methodology and important things about education that I will apply inpeople from my country because I want them to progress in life.


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Personal Statements B

25. Describe a problem or challenging situation that you resolved by using your initiative. What was the outcome?Please select this example carefully. It should illustrate something that you want the review panel to know about yourproblem-solving, leadership abilities, or commitment to public service. Your personal statement should be between450-500 words.

In the school I have worked normally, we use annual plans as a guide to plan our classes weekly. We neverreceived from the Editorial the annual lesson plan; so, my work was to write the annual lesson plans for

three books for preschooler.As teacher we need to be creative and give service, I have helped my colleagues in replacements and also todecorating stages for presentations.As part of a church, with my helpers (sisters in faith that are serving too) we are addressing a group ofleaders for teenagers, there some problems in the organization and first, we created an activity schedulewith all the activities to develop during this years, we did it on December. After that, throughout meetingsand conversations with my helpers that are my friends, we made a schedule to train all the teenagers

leaders from different sector, where they give us written and speech reports about the organization in eachsector is working, their needs and they share with us how we can help them. Also, according therequirements they are trained in order to improve their teaching way and thinking about people they areteaching and working with.

In order to help teenagers to do good and edifying activities, it was organized the boy scouts program not asthe common program , teenagers are taught about survival activities but also about values they need toapply in life.

Nowadays, the organization is much better and people who are involved are motivating even the challengesthey have in order to give a good service to them.


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Substance Abuse Field of Study

NOTE: THIS PAGE SHOULD BE FILLED OUT ONLY BY THOSE APPLICANTS WHOSE PROPOSED FIELD OF STUDY ISSUBSTANCE ABUSE

Please contact the Commission in your country before completing the following: (Your comments should be continued on aseparate sheet if more space is needed.)

1. Briefly describe what you know about current substance abuse problems in your country.

2. Briefly describe recent substance abuse research project(s) in which you have been engaged, the extent of your role in these

project(s), and list any publications in connection with research work that you have done.

3. Briefly describe an area of substance abuse research that you would like to pursue based on the needs in your country.

Personal Information


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I.PERSONAL FINANCIAL INFORMATION(Indicate all funds in your local currency.)

1. Your annual salary $ 5.400

Income per year from other sources:

2. Will your salary be continued during your stay in the U.S.? Yes No

If yes what percentage? 0%

II.DEPENDENTS: The Hubert H. Humphrey Fellowship Program does not provide allowances for dependents. If your

dependents accompany you, you will be responsible for providing all travel, adequate medical insurance, and support for them.English/Orientation Centers cannot accommodate dependents. Dependents may not arrive until you are settled in your

academic program and have found housing (at least 30 days after your arrival at academic placement).

1. Marital status Single

2. List the relationships and ages of any persons who will require financial assistance from you during your academic year in theU.S.:

1. Mother 48 ears 3.

2. 4.

3. Will any dependents accompany you to the U.S.? Yes No

If yes, give name(s) as shown on passport(s), gender, relationship(s), date(s) of birth, city/country of birth and citizenship for eachdependent. Please also state how you intend to provide for them during your year of study in the U.S.

III.ACADEMIC PROGRAM

1. If required, will you be able to arrive for English languagetraining as early as April?

Yes No

2. Will you be able to obtain a leave of absence from yourcurrent position for a period of 11 months, or up to 14 months ifyou require English training?

Yes No

3. When will you take a standardized test that assessed your

English language ability, such as TOEFL? June

If you have not taken the test, contact the Fulbright Commission in Ecuador to register for the English test [email protected].

IMPORTANT

1. An official TOEFL score (no more than two years old) is required for all countries except the English speaking Caribbean.

I hereby authorize the Institute of International Education to receive my TOEFL score report.

Date: _____Thursday, May 16th 2013_____________________________

Signature: __________________________________

English LanguageI.THIS SECTION TO BE COMPLETED BY APPLICANT

Applicants name Solange Guerrero
mailto:[email protected]:[email protected]:[email protected]


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Country of residence: Ecuador

Native (Home) language: Spanish

A. HISTORY OF APPLICANT'S FORMAL STUDY OF ENGLISH

LEVEL NUMBER OF YEARSNUMBER OF

MONTHS PER YEARNUMBER OF HOURS

PER WEEKNATIVE LANGUAGE

OF INSTRUCTOR

Secondary school 6 12 7 Spanish

University 4 12 30 Spanish/English

Private study 1 2 20 English

B. ENGLISH LANGUAGE TESTS

Indicate the date on which you took or will take the official Test of English asa Foreign Language (TOEFL): October 2013

Indicate the TOEFL score earned:

In addition, if you have recently taken or are planning to take one of thefollowing English language proficiency tests, please indicate the test date andthe score (with TOEFL conversion):

Institutional TOEFL (ITP): Date: Score:

Please note: The institutional TOEFL or ITP is the only acceptable test for initial screening. You must still provide anofficial TOEFL score report should you be nominated for the program.


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Applicant Checklist

PLEASE SAVE THIS FORM AND REFER TO ITIN SUBMITTING YOUR APPLICATION!

APPLICANT CHECKLIST

FOR SUBMISSION OF APPLICATION

Completed Application yes

Official transcripts and diplomas

1st Letter of Reference from current employer

2nd Letter of Reference

Substance Abuse Field of Study form if applicable

Contact the Fulbright Commission to register for English exam until June 21, 2013if you do not have an official and valid (within two years) TOELF or IELTS testscore.

Date of English exam June 29, 2013

6587.formulario de aplicacion 2014 2015

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