Inter-Country Travel Grant application form

Administratorem danych osobowych jest Polsko-Amerykańska Komisja Fulbrighta (“Fulbright Poland”) z siedzibą w Warszawie (kod pocztowy 00-688), przy ul. Emilii Plater 28, NIP: 526-17-19-106. Dane podane w formularzu będą przetwarzane zgodnie z niniejszą polityką prywatności:
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Email *
Name and surname, title *
Academic field and specialization: *
Home institution in the U.S. *
Current host country: *
E-mail address: *
N/A if not applicable
The Fulbright travel grant will cover the visiting scholar’s travel costs from the host country to Poland using the economy fare. The host institution is expected to cover other resulting expenses.
Host institution is expected to provide brief report (in English) and at least one picture of the visit.
Institution *
Department/Faculty/Institute *
Postal Address *
Contact person (title, name and surname, e-mail, telephone) *
Proposed dates of visit in Poland: *
Amount of grant requested (travel fare) in PLN or USD (up to 1,000 USD) *
The grant will be reimbursed by the Polish-U.S. Fulbright Commission based on the report of the visit (after its completion) with attached pictures (sent by e-mail to the program’s coordinator).
Please state reasons for inviting this particular scholar (1 to 2 paragraphs): *
Planned lecturer's program in Poland (1 to 2 paragraphs): *
Has the host already been in contact with the scholar regarding the visit? *
Would the host like the Fulbright Commission to initiate contact with the scholar? *
If the host has not had previous contact with the scholar and would like the Fulbright Commission to initiate an invitation, this application should be accompanied by an invitation addressed to the American scholar. The invitation should include information about the inviting institution and suggested topic, activities and dates of the visit.  
Oświadczenie osoby składającej wniosek *
A copy of your responses will be emailed to the address you provided.
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