**UNITED STATES DEPARTMENT OF AGRICULTURE**

> **FACULTY EXCHANGE PROGRAM**
>
> **Agricultural Sciences Application**
>
> Please include with your application:

-   A copy of your international passport

-   Two passport photographs

-   One to three pages about your two most important research interests;
    that is, what research you would like to be involved with during
    your visit. Please give appropriate scientific detail as this will
    be forwarded to the coordinators at our participating U.S.
    universities; they will use this information to more easily match
    your background and needs with those of their U.S. professors.
    Please note that exact matches are not always possible and we ask
    that you be prepared to be flexible and broad-minded.

**\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\--**

> (the grey areas will expand as you fill them in)

**I. Personal Information**

> Family name/Surname (as shown on your passport)      
>
> Given name/First name (as shown on your passport)     
>
> Date of Birth (Day/Month/Year)      
>
> Male Female
>
> City of Birth      
>
> Country of Birth      
>
> Country of Citizenship      
>
> Country of Legal Permanent Residence      
>
> E.mail Address      

#### Home Address

> Number and Street
>
> Town or City      
>
> Country      
>
> Postal Code      
>
> [Telephone Numbers]{.underline} (include city code)

Home      

Office      

Fax      

Mobile/Cell      

**II. Employment** Please tell us about your last three jobs, starting
with your current job

1.  [Current Job]{.underline}

> Dates: from      to present

#####  Name and address of university

> Your title      
>
> Please describe your duties

Please briefly describe your research

2.  [Previous Job]{.underline}

> Dates: from       to      

#####  Name and address of organization

> Your title      
>
> Please describe your duties

Please briefly describe your research

3.  [Previous Job]{.underline}

> Dates: from       to      

#####  Name and address of organization

> Your title
>
> Please describe your duties

Please briefly describe your research

> **III. Experience and Plans**
>
> What are your past teaching experiences in the Agricultural Sciences?
> (Describe the courses and adult education programs that you have
> taught.)
>
> What are the Agricultural Science courses or adult education programs
> that you expect to teach in the future?

What two courses do you wish to revise or create during the program?

Regarding curriculum or teaching, what specifically would you like to
focus upon while in the U.S.?

Regarding research, what specifically would you like to focus upon while
in the U.S.?

> Are you involved with any committees (e.g., advisory committees,
> curriculum reform committees, or any other policy or university
> committees)?
>
> What other sort of training or experience do you hope to get while you
> are in the U.S. that is not available to you now?
>
> Please list the professional contacts that you have in the United
> States.
>
> Name
>
> Address      
>
> Telephone Number      
>
> E.mail
>
> Name
>
> Address
>
> Telephone Number 0
>
> E.mail

[Academic Education]{.underline} (starting with the most current)

1.  Name of University or Institution      

Field of study      

> Type of degree and date received      
>
> Title of Thesis      

2.  Name of University or Institution      

Field of study      

> Type of degree and date received      
>
> Title of Thesis

3.  Name of University or Institution      

Field of study      

> Type of degree and date received      
>
> Title of Thesis

[Training or study in other countries]{.underline}

1.  Field of Study      

Dates      

Country      

2.  Field of Study      

Dates      

Country      

3.  Field of Study      

Dates      

Country      

> **IV. Languages** Please indicate your level of oral communication,
> reading capability, and writing capability on a scale of 1 to 5 where:
>
> **1** is poor **3** is average **5** is fluent
>
> Please list all languages in which you have capabilities, with English
> first.

1.  Language **English**

> Oral Communication rating      
>
> Reading Capability rating **     **
>
> Writing Capability rating **     **

2.  Language      

> Oral Communication rating      
>
> Reading Capability rating **     **
>
> Writing Capability rating **     **

3.  Language      

> Oral Communication rating      
>
> Reading Capability rating **     **
>
> Writing Capability rating **    **

**V. Training Benefits:**

How will you put the knowledge you gain in the U.S. into practice?

How will selecting you for study in the U.S. help your country?

**[Faculty Exchange Program Conditions of Training]{.underline}**

> If I am accepted to receive training under the U.S. Department of
> Agriculture (USDA) Faculty Exchange Program (FEP), I agree to adhere
> to my arranged program, to devote my time and attention to my studies
> and practical training, and to conform to FEP regulations and
> procedures for the duration of my training program. I will not seek
> extension of the period of my program but will return to my country
> without delay upon completion of my training acquired under this
> program. I agree to return to my university to teach for a minimum of
> 2 years. I also agree to conform to all of the laws of the United
> States.
>
> Furthermore, I understand and agree to the following policies of the
> Faculty Exchange Program:
>
> **I. Dependents**
>
> USDA strongly discourages family members from accompanying or joining
> a participant while they are in the U.S. on the program. The Faculty
> Exchange Program is not responsible in any way for family members. If
> dependents do wish to come to the U.S., the participant is responsible
> for showing proof of health insurance coverage that equals or exceeds
> the coverage required by U.S. visa regulations.
>
> **II. Attendance of Participants at Conferences and Meetings**
>
> Attendance of participants at national or international conferences,
> conventions, or meetings of professional, trade, or other associations
> is not permitted unless such attendance is a part of the approved
> Faculty Exchange Program.
>
> **III. Conditions for Termination of Training Programs**
>
> USDA reserves the right to terminate the training program of those
> participants who:

-   Change the course of study without authorization from the USDA
    Faculty Exchange Program, or

-   Fail to show sufficient interest in or to pursue effectively their
    training program, or

-   Have severe mental or physical health problems, or

-   Conduct themselves in a manner prejudicial to the program or to the
    laws of the United States, or

-   Marry during training without securing prior USDA approval, or

-   Have falsified information on the application and/or supporting
    documents, or

-   Fail to maintain health insurance for dependents in U.S., or

-   Accept payment for work performed while in the U.S.

> **IV. Travel**
>
> If selected, the participant will travel on the tickets and according
> to the arrangements made by the USDA. The USDA will pay for round-trip
> transportation to and from the participant\'s country's capital city
> to the United States. The participant is responsible for all costs
> associated with traveling to and from their home to the capital city
> at the beginning and end of the program.

**V. Financial Support**

> The applicant is aware that the financial support provided by the USDA
> Faculty Exchange Program is for training fees, emergency medical
> insurance, lodging, food, and incidentals only. USDA does not fund any
> expenses related to family members accompanying participants. During
> the program lodging is arranged by the USDA. You will share a bedroom
> with another participant during your stay in the U.S.
>
> Participants are not allowed to earn wages or a salary from work
> performed in the U.S. during their stay under this program.
>
> **VI. Health and Insurance**
>
> It is a requirement that every participant have a physical examination
> prior to their arrival in the United States and be determined to be in
> excellent health. Those accepted into the program are responsible for
> arranging and paying for a physical examination. A form will be
> provided by the USDA during in-country interviews. Those accepted will
> be instructed to have this form completed and signed by a qualified
> physician certifying that the participant is in good health.
>
> The insurance provided to each participant while in the United States
> will cover only emergency medical care. **This insurance does not
> cover** pre-existing conditions, prescriptions, or dental or optical
> work. In addition, the participant must pay a percentage of medical
> expenses for each occurrence.
>
> **VII. Debts and Obligations**
>
> The participant will be responsible for all debts and financial
> obligations incurred while in the United States.
>
> Sign below to indicate your understanding of and agreement to the
> above conditions:
>
> \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
> \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_\_\_
> Applicant\'s Name (printed) Applicant\'s Signature Date
>
> **The United States Department of Agriculture**
>
> **Faculty Exchange Program**
>
> **in the Agricultural Sciences**
>
> **Dear Rector or Dean:**

In what way would the participation of this applicant be advantageous to
your university?

What would you like the applicant to accomplish while they are in the
United States on the Faculty Exchange Program?

How will their suggestions and ideas be considered and implemented?

> [\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_]{.underline}
> \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
> \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
>
> Name of Rector or Dean Signature of Rector or Dean Date
>
> **The United States Department of Agriculture**
>
> **Faculty Exchange Program**
>
> **in the Agricultural Sciences**

# 

# 

# Dear Vice Rector or Vice Dean:

> Which skills and understandings of your recent graduates are most in
> need of strengthening?
>
>      

Regarding curricula development, what would you like the applicant to
accomplish while they are in the United States under the Faculty
Exchange Program?

>      

Regarding research and collaboration, what would you like the applicant
to accomplish while they are in the United States under the Faculty
Exchange Program?

>      
>
> [\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_]{.underline}
> \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
> \_\_\_\_\_\_\_\_
>
> Name of Vice Rector or Vice Dean Signature of Vice R. or Vice D. Date
>
> **The United States Department of Agriculture**
>
> **Faculty Exchange Program**

# in the Agricultural Sciences

# 

# Dear Department Head:

> How will you adjust and manage the operation of your department while
> the applicant is in the United States?
>
>      

In what way would the participation of this applicant be advantageous to
your Department?

What elements of agricultural sciences do you want the applicant to
focus upon while they are in the U.S.?

What aspects of curricula development do you want the applicant to focus
upon while they are in the U.S.?

> [\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_]{.underline}
> \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
> \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
>
> Name of Department Head Signature of Department Head Date
>
> **The United States Department of Agriculture**
>
> **Faculty Exchange Program**

# in the Agricultural Sciences

**Dear Supervisor:**

> What are some of the professional strengths of this applicant?

What do you want the applicant to focus upon while in the United States?

>      
>
> \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
> \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
> \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
>
> Name of Supervisor Signature of Supervisor Date

##   {#section-3 .unnumbered}

## Letter of Commitment 

> **from**
>
>      
>
> **(Name of University)**
>
> **to the**
>
> **United States Department of Agriculture**
>
> **Faculty Exchange Program**
>
> The university administrators who have signed below commit themselves
> to releasing (name of applicant)       to go to the United States if
> selected by the Department of Agriculture to participate in the
> Faculty Exchange Program. The university administration agrees to
> continue to pay the participant their full salary while they are
> participating in the Faculty Exchange Program.
>
> The university administration authorizes the participant to bring
> copies of the university\'s curricula, course outlines, and teaching
> materials to the U.S. to be used by the participant for review, study,
> and comparison.
>
> The university understands and accepts that the participant will
> develop proposals and try to suggest changes that they believe will
> improve this university\'s curricula, courses, and teaching methods.
>
> The university administration agrees to consider in good faith
> proposals for change and to create opportunities for returning
> participants to share these ideas with other instructors at your
> university.
>
> The university administration promises to guarantee continued
> employment at a position of the same or improved responsibility to the
> participant when they return from the U.S.
>
> **Please sign:**
>
> Rector or Dean
> \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
>
> Vice Rector or Vice Dean
> \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
>
> Department Head
> \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Supervisor
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

> **Date:** \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_