Travel Grant Application

Overseas Travel Grant Application

AICEF Travel Grants are specifically for citizens of the Republic of Indonesia currently enrolled at a US educational institution who plan to do part or all of their PhD dissertation research in Indonesia. If you are not an Indonesian student, please do not apply. To complete this form you will need the name and email address of the person you have asked to provide the required letter of recommendation.
Citizenship
Amount of Grant Requested
You will be asked to provide a budget later in this application.
Personal Information
Name

First NameLast Name
Email
Phone Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Single
Number of Dependents (not including yourself)
Type of US Visa (A,B,F,J etc.)
Enrollment Date

MonthDayYear
Visa Upload

Please upload a photo of your visa as it appears in your passport
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Visa Expires

MonthDayYear
Date
Completion Date

MonthDayYear
Date you expect to complete your degree
Passport

Please upload the main page of your passport
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Education
Name of College/University
Cumulative GPA
Course of Study/Major
Degree Expected
Please list the name, enrollment dates, and degrees you obtained at any other College/University.
Have you completed all of your degree requirements except your dissertation?
Do you have an approved dissertation proposal?
Does your dissertation require you to travel and conduct research/field work in Indonesia?
Provide a brief description of your dissertation proposal
You may upload a document version of your proposal later in the application. If so, just answer "document attached" here

Work Experience
Please list up to three of your past employers, the position you held, and the dates of your employment.
You may submit this information as part of your CV which can be uploaded at the end of the application.
Personal Statement
Briefly describe the career you intend to pursue, how you expect this course of study to contribute to it, and the expected benefit to Indonesia and its people.
You may attach this at the end of the application. If so enter "see attachment."
Briefly describe any Honors, previously written thesis, interests, or other talents.
You may submit this information as part of a CV or resume that can be uploaded at the end of the application.
Will you be returning to Indonesia after you complete your degree?
If yes, please provide us with a forwarding address in Indonesia (include your phone number if possible).
Have any of your relatives previously received financial support from the Foundation?
Name of Relative
Are any of your relatives currently receiving or applying for financial support from the Foundation?
Relative's Name

FINANCIAL INFORMATION
List all scholarships and other financial assistance that you are presently receiving, noting the source and amount.
Your Own Funds
Paid Assistantship
Other Earnings
Earnings Source/s
Grants, Fellowships, etc.
Grants and Fellowships Source/s
Tuition Waiver
Loans
Loan Sources
Please explain and itemize the costs and how exactly the requested funds will be used (international air travel, domestic travel, lodging, supplies, equipment, etc.).

Signature, File Upload, Recommendation
Name of Recommender
Please enter name of who you have asked to submit a recommendation
Recommender's Email
example@example.com
Optional Document Upload

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Optional Document Upload

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Signature: I verify that the information I have submitted is correct to the best of my knowledge.
Please verify that you are human
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Overseas Travel Grant Application