2017U.S. Department of State and espnW Global Sports Mentoring Program

Application Checklist

Name
Age
Gender
Governorate
Previous travel to the U.S.? If yes, please specify duration and type of visit
Egyptian Citizen / Yes
No
Number of Years of Work Experience
Current Employer
Level of Education (bachelors, masters, PhD, other)

In order for your application to be complete, please make sure you have:

Completed application checklist form (this page)

Completed application form (pages 2- 6 of this document)

Copy of passport

Most recent curriculum vitae

One or two recommendation letter(s)

Inquiries:

Inquiries should be sent by email to . Inquiries will be answered within 3 working days.

Applications must be received by April 3, 2017 by 2:00 pm. Late applications will not be considered. Applications can only be submitted by post, or in person as explained below. Applications sent electronically will not be considered.

  • Postal Submission: If you would like to submit your application by mail please send by some type of courier service that is dependable and requires signature upon delivery. Write your full name, list the program name and institute on the envelope.
  • Hand Delivered Submission: Hand delivered applications will be accepted at the U.S. Embassy in Cairo. Applications must be HAND delivered in OPEN envelopes to the Checkpoint guard at the North Gate of the U.S. Embassy (8, Kamal El Din Salah Street, Garden City), Sunday through Thursday between 11:00 a.m. and 2:00 p.m. (work days only*). Write your full name, list the program name and institute on the envelope.

*The US Embassy in Cairo closes on Fridays and Saturdays

  • If sending by post or hand delivery please use the following address:

U.S. Embassy in Cairo, Public Affairs Section, Exchanges Office

North Gate, 8 Kamal El Din Salah Street, Garden City, Cairo, Egypt

  • All application must be completed in full in English by the applicant. The application must be type-written; hand-written applications will not be accepted. Incomplete applications will not be considered.
  • All essays should be type-written in English. Essays must be written in the applicant’s own words and not contain text taken from the Internet, books, or other sources. Applications containing even one sentence of plagiarized text will be disqualified automatically. For a definition of plagiarism please visit for guidance on how to avoid plagiarism.

Remark: Only short-listed applicants will be contacted for interviews and will be asked to send their applications by e-mail. Please keep an electronic type-written copy of completed application.

U.S. Department of State and espnW Global Sports Mentoring Program

Application Form 2017

  • Name: ______

(First name) (Middle name) (Last name)

  • City and Country of Birth:
  • Date of Birth written in full:______

(Month) (Day) (Year)

  • Passport no:

Date of issuance: ______

(Month) (Day) (Year)

Date of expiration: ______

(Month) (Day) (Year)

  • Marital Status:
  • Citizenship:
  • Special considerations, such as allergies, medical and physical challenges, dietary preferences:
  • Business address, telephone and fax numbers:
  • E-mail address:
  • Home address and telephone:
  • Mobile Number:
  • Preferred Mailing Address: Business ( ) Home ( )
  • Languages:
  • Native Language:
  • English Proficiency:
  • Speaking:
  • Comprehension:
  • Written:
  • Social Media:If available, please provide information on any social media tools that you may use. These include Twitter, Facebook personal account, Facebook organization account, or other.
  • Present Position: (exact title, starting date, and brief description of role in company/organization)
  • Full Name of Company/Organization:
  • Brief Description of Company/Institution: (Please Include information on the organization's sector (private, public, non-governmental), number of employees, annual budget, annual revenue, organization mission, relevance to the sports sphere, and website)
  • Professional memberships in local, national or international professional organizations or associations or clubs:
  • Previous travel to the United States: (Please note if applicant has ever traveled on a U.S. government program)
  • Dates:
  • Places Visited:
  • Sponsorship/Purpose of Visit:
  • Other Travel Abroad
  • Dates:
  • City and Country:
  • Principal Purpose of Visit:
  • Dates:
  • City and Country:
  • Principal Purpose of Visit:
  • Dates:
  • City and Country:
  • Principal Purpose of Visit:
  • Educational Background: (List highest degree first. Include significant training programs)
  • Dates:
  • Degree/Certificate:
  • Institutions:
  • Field of Specialization:
  • Other Interestsand endeavors outside of work: (Hobbies, Volunteer Activities, etc.)

PERSONAL STATEMENT

Please answer all of the following questions in your personal statement: This can be more than one page, but it is important that all sixquestions are answered in the following order.
1-Why do you think you will be a good fit for this exchange program?
2-What do you hope to gain from the mentorshipexperience and how will you maximize the opportunity?
3-What are your personal, executive, and technical strengths?
4-What are your accomplishments and contributions to society, particularly in the context of sports and female empowerment?
5-How do you expect the program to impact your work when you return to Egypt?

RECOMMENDATION CONTACT

Identify one individual (or more) who can provide you a letter of recommendation (other than the one to be submitted with the application). Please have this/these recommendation(s) letter ready with you if you are called back for an interview.

Name
Title
Mailing Address
Telephone Number
Email Address
Name
Title
Mailing Address
Telephone Number
Email Address

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