APPLICATION FORM

USEFP - Fulbright Alumni Grants

For Academic Activities

Name of the Alumni:

Name of the Employer/Institution:

Title & Purpose of the activity:

Date and Venue of the activity:

Total budget for the activity: Rs.

Amount requiredfrom USEFP: Rs.

Amount Committed by Joint Sponsoring Agency: Rs.

List major budget items:

How do you plan to spend the grant?

How many people will participate? (Please attach list, with phone & e-mails, if possible)

Names of presenters/resource persons: (Please attach list, with phone & e-mails)

As USEFP-Fulbright Alumni Grants applicant, prior to receiving the grant I agree to abide by the following terms and conditions to utilize this grant for the given purpose:

  1. USEFP grant funding maximum amount of $2,000 (in PKR equivalent to current USD exchange rate) will only be utilized by me for expenditures related to the USEFP approved activity.
  2. USEFP will release 60% of the total approved grant amount in advance and the remaining 40% will be paid to me after completion of the grant activity and submission of post event documentation.
  3. USEFP will release the 60% and 40% payments through cross check in my favor drawn on following bank account:

Account Title: ______Account #: ______

Bank Name: ______Branch/City: ______

  1. In case, the event is not held within 90 days, I undertake to return the 60% amount within one week from the end of the 90 days period, through cross check favoring “United States Educational Foundation in Pakistan” (USEFP).
  2. I undertake to submit actual expenditure statement and claim within fifteen days of holding the event.
  3. In case, actual expenditure is less than 60% of the payment received, I undertake to return the unused balance amount through cross check favoring “United States Educational Foundation in Pakistan”. The financial reporting form and the actual expenditure will be submitted together with the supporting described in clause 7 below.
  4. USEFP will only release the balance of 40% payment tranche upon submitting the following documentation by me:
  5. Financial Reporting Form (Annexure A);
  6. Expenditure statement disclosing breakdown of expenditure supported by all original expenditure receipts for all payments made out of the grant;
  7. Name(s) and contact information of presenter(s)/resource person(s), telephone and email.
  8. Participant attendance list with contact details, telephone and e-mail;
  9. Evidence of holding the activity: through visual proof – photographs and/ or videos, of placement of USEFP branding and promotional materials, including any IEC materials produced for the purpose of the grant activity;
  10. USEFP shall review all supporting financial documents and receipts and evidences. In case, any items of expenditure or supporting documents lack clarity or have unsatisfactory supporting, such item(s) will not be considered as allowable expense.
  1. No payment or benefit should directly or indirectly be passed on by way of fee, consultation charges, dividends, bonus or any other category of expenditure(s), to any related office bearer or members.
  2. Grant recipient including his spouses/dependants shall not be entitled to any remuneration by virtue of acting in such capacity.
  3. USEFP representative(s) are entitled to attend or visit the activity/event at their discretion.
  4. As a Grant recipient, I undertake not to collect and receive any funds from participants or third parties for this approved activity. In case the event is co-sponsored by any other agency, this will require approval of the financial plan and content of the activity by USEFP through the approved activity plan.
  5. I shall not apply for another USEFP-Fulbright Alumni Grants unless the existing grant expenditure is submitted by me and final clearance is granted by USEFP.
  6. Alumni can avail up to a maximum of two grants in a five year period
  7. No payments from the stipulated grant fund may be paid towards department or higher education institution overheads

Signature: Date:
Name: CNIC:
Address:

Only for use of United States Educational Foundation in Pakistan:

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