Inter-Country Travel Grant
Application form
Email address *
AMERICAN SCHOLAR
Name and surname, title *
Your answer
Academic field and specialization: *
Your answer
Home institution in the U.S. *
Your answer
Current host country: *
Your answer
E-mail address: *
Your answer
HOST INSTITUTION
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 Polish or English) and at least one picture of the visit.
Institution *
Your answer
Department/Faculty/Institute *
Your answer
Postal Address *
Your answer
Contact person (title, name and surname, e-mail, telephone) *
Your answer
Proposed dates of visit in Poland: *
Your answer
Amount of grant requested (travel fare) in PLN or USD *
The grant will be reimbursed by the Polish-U.S. Fulbright Commission based on the report of the visit with attached pictures (sent by e-mail to the program’s coordinator) and the signed Reimbursement Claim Form (sent by mail at the Commission’s address), both submitted after the visit’s completion.
Your answer
Please state reasons for inviting this particular scholar (1 to 2 paragraphs): *
Your answer
Planned lecturer's program in Poland (1 to 2 paragraphs): *
Your answer
Has the host already been in contact with the scholar regarding the visit? *
Required
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.
Required
I hereby give consent for my personal data included in this application form application to be processed by the Polish-U.S. Fulbright Commission in order to review this application, under the Personal Data Protection Act as of 29 August 1997, consolidated text: Journal of Laws 2016, item 922 as amended. *
Giving consent is required to send the application.
A copy of your responses will be emailed to the address you provided.
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