Resident Kelly Fellowship Application

Resident Kelly Fellowship Application

Applications due by May 31, 2026.
Please select your desired six-month or one-year resident fellowship period:

Other
Personal Data
Name

Surname (Last) Name Given (First) Name
Country of Citizenship
Permanent Address

Street Address

Street Address Line 2

CityState / Province / Country

Postal / Zip Code
Date of Birth

MonthDayYear
Gender

Other
Phone Number (work, home, or mobile)

Country/Area CodePhone Number
Primary Email
Secondary Email
Proposed Research Topic
Research Interests

Education

Rows	Degrees Obtained or In Progress	Major	Name of School	Month/Year Degree Received or Expected
1
2
3
4

Provide two references we can contact.

Immigration
If not U.S. citizen, but currently in U.S., what is your visa status?
I-94 number:
Immigration Start Date

MonthDayYear
Expiration Date

MonthDayYear
If currently in J status, do you have medical coverage of at least: $100,000 per accident/illness, $25,000 for repatriation, $50,000 for medical evacuation, and $500 deductible for yourself and your dependent(s)?
Have you been in the U.S. on J-1 or J-2 status within the past 24 months?
If yes, please attach copies of all previous DS-2019s.

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Upload materials

Please upload your cover letter, resume, description of research project, a letter of recommendation and any other supplemental documents below. Recommendation letter may be submitted separately by the letter writer to rob@pacforum.org or along with the required materials listed above.
1. Cover letter

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2. CV/Resume

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3. Description of research project

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4. Letter of recommendation

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5. Brief Biography

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Applicant's Certification
I, the undersigned, hereby certify that the information I have given on this application is complete and correct to the best of my knowledge and that I have attended no institution other than those listed on this application. I understand that the concealment of such information may result in the rejection of my application or disciplinary action if discovered after acceptance.
Signature
Date

MonthDayYear
Should be Empty:

Personal Data