+-----------------------------------------------------------------------+
| # **Archived Information**                                            |
|                                                                       |
| # **U.S. DEPARTMENT OF EDUCATION**                                    |
|                                                                       |
| OFFICE OF POSTSECONDARY EDUCATION                                     |
|                                                                       |
| INTERNATIONAL EDUCATION PROGRAMS SERVICE                              |
|                                                                       |
| Washington, D.C. 20006-8521                                           |
|                                                                       |
| ![](media/image1.wmf)                                                 |
|                                                                       |
| # **FISCAL YEAR 2009**                                                |
|                                                                       |
| #### APPLICATION FOR THE                                              |
|                                                                       |
| **FULBRIGHT-HAYS SEMINARS ABROAD PROGRAM**                            |
|                                                                       |
| ### CFDA No. 84.018                                                   |
|                                                                       |
| ### CLOSING DATE:                                                     |
|                                                                       |
| September 12^th^, 2008                                                |
|                                                                       |
| Elementary Education- India, Mexico, New Zealand & Mongolia           |
|                                                                       |
| Secondary Education- China: Foreign Language, Poland, Turkey          |
|                                                                       |
| Postsecondary Education- Jordan & Oman, China: History & Culture,     |
| Senegal                                                               |
|                                                                       |
| ### DATED MATERIAL -- [OPEN IMMEDIATELY]{.underline}                  |
|                                                                       |
| OMB No. 1840-0501                                                     |
+-----------------------------------------------------------------------+

**INSTRUCTIONS FOR TRANSMITTING APPLICATIONS**

Applications for grants under the Fulbright-Hays Seminars Abroad
Program, CFDA 84.018A must be submitted electronically using
e-Application available through the Department's e-Grants system.

When using e-Application to complete the application, you will be
entering data online. Do not e-mail an electronic copy of any part of a
grant application to us. The data that is entered online will be saved
into a database.

If you participate in e-Application, please note the following:

-   You must submit the grant application electronically through the
    Internet using the software provided on the e-Grants Web site
    ([http://e-grants.ed.gov](http://e-grants.ed.gov/)) by 4:30 p.m.,
    Washington, DC time, on the application deadline date. The regular
    hours of operation of the e-Grants Web site are 6:00 a.m. Monday
    until 7:00 p.m. Wednesday; and 6:00 a.m. Thursday until midnight
    Saturday, Washington, DC time. Please note that the system is
    unavailable on Sundays, and after 7:00 p.m. on Wednesdays for
    maintenance, Washington, DC time. Any modifications to these hours
    are posted on the e-Grants Web site. We strongly recommend that you
    do not wait until the application deadline date to initiate an
    e-Application package.

-   Our office will not accept any application in hard copy unless you
    have contacted our office and received permission to submit the
    application in hard copy. All requests for submitting applications
    in hard copy must be received and approved two weeks prior to the
    deadline.

-   You will not receive additional point value because you submit the
    application in electronic format,

-   After you submit your application to the Department, you will
    receive an automatic acknowledgement- via email, which will include
    a PR/Award number (an identifying number unique to your
    application).

Application Deadline Date Extension in Case of System Unavailability: If
you are prevented from submitting your application on the application
deadline date because the e-Application system is unavailable, we will
grant you an extension of one business day in order to transmit your
application electronically, by mail, or by hand delivery. We will grant
this extension if\--

> 1\. The applicant is a registered user of e-Application and has
> initiated an
>
> e-Application for this competition; and
>
> 2\. (a) The e-Application system is unavailable for 60 minutes or more
> between the hours of 8:30 a.m. and 3:30 p.m., Washington, DC time, on
> the application deadline date; or (b) The e-Application system is
> unavailable for any period of time during the last hour of operation
> (that is, for any period of time between 3:30 p.m. and 4:30 p.m.,
> Washington, DC time) on the application deadline date.

We must acknowledge and confirm these periods of unavailability before
granting you an extension. To request this extension or to confirm our
acknowledgement of any system unavailability, you may contact either (1)
the person listed above or (2) the e-Grants help desk at 1-888-336-8930.

**Important Information for Applicants**

To access an electronic copy of the application please go to our
website:

[www.ed.gov/programs/iegpssap/index.html](http://www.ed.gov/programs/iegpssap/index.html)

For answers to program related questions please contact the program
officers:

Senior Program Officer:

######  Gale Holdren

202-502-7691

> <gale.holdren@ed.gov>
>
> Seminars Abroad Program Assistant:
>
> Michelle Ward
>
> 202-502-7623
>
> <michelle.ward@ed.gov>

PLEASE NOTE:

[All Applicants Will Be Notified of the Results of the
Competition]{.smallcaps}

[NO Earlier Than Late **MARCH**]{.smallcaps}

Dear Applicant:

Thank you for your interest in applying for a grant under the
Fulbright-Hays Seminars Abroad (SA) program. Included in this
application booklet are the program introduction, instructions, and
forms needed to submit a complete application package to the U.S.
Department of Education.

The SA program supports short-term study and travel seminars abroad for
U.S. educators in the social sciences and humanities for the purpose of
improving their understanding and knowledge of the peoples and cultures
of other countries.

This letter highlights a few items in the Fiscal Year (FY) 2009
application package that will be important to you in applying for grants
under this program. You should review the entire application package
carefully before preparing and submitting your application. Information
on the SA Program is accessible at the U.S. Department of Education Web
site at:

[www.ed.gov/programs/iegpssap/index.html](http://www.ed.gov/programs/iegpssap/index.html)

The application must be submitted on or before the deadline date.
Electronic submission of applications is required; therefore, you must
submit an electronic application unless you follow the procedures
detailed in the SA application and qualify for one of the exceptions to
the electronic submission requirement. The requirements for obtaining an
exception to the electronic submission have changed. If you think you
may need an exception you are urged to review the requirements promptly.
Applications submitted late [will not be accepted]{.underline}. **We
suggest that you submit your application several days before the
deadline date of September 12, 2008.** The Department is required to
enforce the established deadline to ensure fairness to all applicants.
No changes or additions to an application will be accepted after the
deadline date.

A program officer is available to provide technical assistance if you
have any questions after reviewing the application. Please refer to the
introduction that follows for the names and telephone numbers of the
contact persons.

We look forward to receiving your application and appreciate your
efforts to promote excellence in international education.

> Sincerely,
>
> Diane Auer Jones
>
> Assistant Secretary
>
> Office of Postsecondary Education

**BACKGROUND INFORMATION**

**[The J. William Fulbright Foreign Scholarship Board]{.underline}**

The J. William Fulbright Foreign Scholarship Board has the overall
responsibility for managing the Fulbright Program worldwide. The Board
is composed of twelve members drawn from academic, cultural and public
life who are appointed by the President of the United States. Their job
is to set and interpret policies related to the administration of the
Fulbright Programs, to approve the final selection of all Fulbright
grantees and participants, and to supervise the conduct of the program
both in the U.S. and abroad.

**[The Seminars Abroad Program]{.underline}**

The Seminars Abroad Program, authorized by the Mutual Educational and
Cultural Exchange (Fulbright-Hays) Act of 1961, provides opportunities
for qualified U.S. educators to participate in short-term seminars
abroad mainly on topics in the social sciences, social studies and the
humanities.

The purpose of the program is **to help U.S. educators/administrators in
humanities, languages, and/or area studies to** enhance their
international understanding and increase their knowledge of the people
and culture of another country through study abroad. **This program is
designed for educators with limited or no experience in the host country
(ies).** Upon their return, participants are expected to share their
broadened knowledge and understanding of the host country (ies) with
students, colleagues, civic and professional organizations, and the
public in their respective home communities.

All seminars are composed of a pre-arranged, structured academic phase
and a group travel phase. Due to the group nature of the seminar and the
requirement that participants attend all scheduled activities,
participants will not have time to engage in extensive individual
research. The seminars' schedules provide only a limited amount of free
time for participants to gather information related to their individual
curriculum projects or other projects related to their current teaching
responsibilities.

**PROGRAM GUIDELINES**

**[Eligibility Requirements]{.underline}:**

In accordance with the Policy Statements of the J. William Fulbright
Foreign Scholarship Board, the basic eligibility requirements are:

1.  [Citizenship]{.underline} - must be a citizen of the United States
    or a permanent resident.

2.  [Academic Preparation]{.underline} - must hold at least a bachelor's
    degree from an accredited college or university.

3.  [Professional Experience]{.underline} - (1) must have at least 3
    years of full-time experience **-** by the time of departure for the
    seminar- (2) must be currently employed full-time in a U.S. school
    system, institution of higher education, Local Education Agency,
    State Education Agency, library, or museum. Teaching as a graduate
    or teaching assistant is not applicable toward the three years of
    required full-time professional experience*.*

```{=html}
<!-- -->
```
4.  Applications are accepted from those who teach two half-time
    permanent positions in two different institutions, teaching at the
    same or similar education levels. You must provide documentation
    that both positions add up to the equivalent of a full-time
    position.

5.  [Health]{.underline} --The candidate must be physically and
    psychologically able to participate in all phases of the seminar.
    Award recipients must provide a physician's statement to reflect
    participants' readiness for travel.

6.  [Suitability and Adaptability]{.underline} - The applicants'
    suitability and adaptability are assessed through the evaluation
    criteria and letters of reference.

## Curriculum Project and Final Report

Any applicant who has participated in the Fulbright-Hays Seminars Abroad
or Group Projects Abroad program (s) and has not completed the program
requirement of a curriculum project and final report will have their
application deemed ineligible.

> All applications are reviewed and evaluated according to their *first
> choice* unless an applicant is deemed ineligible for his or her first
> choice. **Applicants are encouraged to list a second choice when
> applying. If an applicant selects a second choice and does not discuss
> the selection in the essay questions, points will be deducted.**

Applicants are considered for their second choice seminar if they score
high enough in the competition but do not make the cut-off for their
first choice seminar.

If too few applications are received for a given seminar that seminar
will be cancelled. Applicants who have selected a cancelled seminar as
their first choice will be reviewed for their second choice, if the
applicant lists a second choice. If they meet the qualifications for
those seminars, they will be selected to participate in either their
second choice.

# **[Program Requirement]{.underline}**

The requirement to participate in the SA program is the completion of a
curriculum project that must be submitted to the agency administering
the seminar, 90 days after the conclusion of the seminar.

**[Ineligibility Factor]{.underline}**

Those individuals who have participated in the Fulbright-Hays Seminars
Abroad Program or Group Projects Abroad Program or the Japan Fulbright
Memorial Fund must wait two summers before they are eligible to
participate a second time; i.e., those individuals who participated in a
seminar or group project in 2007 or 2008 are not yet eligible to
reapply.

+-------------------------------------------------+--------------------+
| ######### U.S. Department of Education          | FORM aPPROVED      |
|                                                 |                    |
| ######### Washington, DC 20006                  | oMB no. 1840-0501  |
|                                                 |                    |
| **APPLICATION FOR FULBRIGHT-HAYS SEMINARS       | Expiration Date:   |
| ABROAD PROGRAM**                                | 07/31/2009         |
|                                                 |                    |
| **(P.L. 87-256, as amended)**                   |                    |
|                                                 |                    |
| **PART A. Application Information**             |                    |
+-------------------------------------------------+--------------------+
| According to the Paperwork Reduction Act of     |                    |
| 1995, no persons are required to respond to a   |                    |
| collection of information unless such           |                    |
| collection displays a valid OMB control number. |                    |
| The valid OMB control number for this           |                    |
| information collection is 1840-0501. The time   |                    |
| required to complete this information           |                    |
| collection is estimated to average four hours   |                    |
| per response, including the time to review      |                    |
| instruction, search existing data resources,    |                    |
| gather the data needed, and complete and review |                    |
| the information collection. If you have any     |                    |
| comments concerning the accuracy of the time    |                    |
| estimate or suggestions for improving this      |                    |
| form, please write to: U.S. Department of       |                    |
| Education, Washington, DC 20202-4651. If you    |                    |
| have comments or concerns regarding the status  |                    |
| of your individual submission of this form,     |                    |
| write directly to International Education and   |                    |
| Graduate Programs Service, U.S. Department of   |                    |
| Education, 1990 K Street, NW -- 6^th^ Floor,    |                    |
| Washington, DC 20006-8521.                      |                    |
+-------------------------------------------------+--------------------+
| **1. Applicant's Basic Data (please print or    |                    |
| type)**                                         |                    |
+-------------------------------------------------+--------------------+
| **A. Name**: **B.** Mr. Mrs. Ms. Dr.            |                    |
|                                                 |                    |
| (Last) (First) (M.I.)                           |                    |
|                                                 |                    |
| **C. Home Address**:                            |                    |
|                                                 |                    |
| (Number and Street including Apt. #)            |                    |
|                                                 |                    |
| (City) (State) (Zip Code)                       |                    |
|                                                 |                    |
| **D. Home Telephone**: **E. Date of             |                    |
| Birth**: - - 19 **F. Place of Birth:**          |                    |
|                                                 |                    |
| **G. Home email:**                              |                    |
+-------------------------------------------------+--------------------+

+--------------+---------------+------------------+-------------------+
| **H. Seminar | ### Semin     | ### Sem          | **I. US           |
| Preference** | ar Preference | inary Preference | Citizen/**        |
|              |               |                  |                   |
| **Elementary | **Secondary   | ### Postsec      | ##### P           |
| Education**  | Education**   | ondary Education | ermanent Resident |
|              |               |                  |                   |
|              |               |                  | ##### Ple         |
|              |               |                  | ase Circle YES NO |
+--------------+---------------+------------------+-------------------+
| First Choice | First Choice  | First Choice     | **J. Veteran's    |
|              |               |                  | Status ○**        |
+--------------+---------------+------------------+-------------------+
| Second or    | Second or     | Second or Third  |                   |
| Third Choice | Third Choice  | Choice           |                   |
| (optional)   | (optional)    | (optional)       |                   |
+--------------+---------------+------------------+-------------------+
| **K.         |               |                  |                   |
| Emergency    |               |                  |                   |
| Contact**    |               |                  |                   |
|              |               |                  |                   |
| **Name**:    |               |                  |                   |
| **           |               |                  |                   |
| Telephone:** |               |                  |                   |
|              |               |                  |                   |
| (Last)       |               |                  |                   |
| (First)      |               |                  |                   |
| (M.I.)       |               |                  |                   |
|              |               |                  |                   |
| **Home       |               |                  |                   |
| Address**:   |               |                  |                   |
|              |               |                  |                   |
| (Number and  |               |                  |                   |
| Street       |               |                  |                   |
| including    |               |                  |                   |
| Apt. #)      |               |                  |                   |
|              |               |                  |                   |
| (City)       |               |                  |                   |
| (State) (Zip |               |                  |                   |
| Code)        |               |                  |                   |
+--------------+---------------+------------------+-------------------+
| **2.         |               |                  |                   |
| Previous     |               |                  |                   |
| Fulbright-   |               |                  |                   |
| Hays or      |               |                  |                   |
| Fulbright    |               |                  |                   |
| Memorial     |               |                  |                   |
| Fund**       |               |                  |                   |
|              |               |                  |                   |
| #######      |               |                  |                   |
|              |               |                  |                   |
| #######      |               |                  |                   |
| Title of Gra |               |                  |                   |
| nt/Award Hos |               |                  |                   |
| t Country Da |               |                  |                   |
| te of Award  |               |                  |                   |
| (month/year) |               |                  |                   |
|              |               |                  |                   |
|   -- -- ---  |               |                  |                   |
|              |               |                  |                   |
|              |               |                  |                   |
|   -- -- ---  |               |                  |                   |
+--------------+---------------+------------------+-------------------+
| **3. Present |               |                  |                   |
| Employment** |               |                  |                   |
+--------------+---------------+------------------+-------------------+
| **Number of  |               |                  |                   |
| years in     |               |                  |                   |
| present      |               |                  |                   |
| position**   |               |                  |                   |
| Full Time    |               |                  |                   |
| Part Time    |               |                  |                   |
+--------------+---------------+------------------+-------------------+
| **A.**       |               |                  |                   |
| **Po         |               |                  |                   |
| sition/Title |               |                  |                   |
| Date of      |               |                  |                   |
| E            |               |                  |                   |
| mployment**: |               |                  |                   |
|              |               |                  |                   |
| Name of      |               |                  |                   |
| Institu      |               |                  |                   |
| tion/School: |               |                  |                   |
|              |               |                  |                   |
| Address      |               |                  |                   |
|              |               |                  |                   |
| Telephone    |               |                  |                   |
| Number: Fax  |               |                  |                   |
| Number: Work |               |                  |                   |
| E-mail:      |               |                  |                   |
+--------------+---------------+------------------+-------------------+
| **Academic   |               |                  |                   |
| Level        |               |                  |                   |
| Taught**     |               |                  |                   |
| (Please      |               |                  |                   |
| check the    |               |                  |                   |
| appropriate  |               |                  |                   |
| academic     |               |                  |                   |
| level)       |               |                  |                   |
|              |               |                  |                   |
| Elementary   |               |                  |                   |
| School       |               |                  |                   |
| Middle       |               |                  |                   |
| School       |               |                  |                   |
| Secondary    |               |                  |                   |
| School       |               |                  |                   |
|              |               |                  |                   |
| P            |               |                  |                   |
| ostsecondary |               |                  |                   |
| (2yr.)       |               |                  |                   |
| P            |               |                  |                   |
| ostsecondary |               |                  |                   |
| (4yr.)       |               |                  |                   |
|              |               |                  |                   |
| Curriculum   |               |                  |                   |
| Specialist   |               |                  |                   |
| Other:       |               |                  |                   |
+--------------+---------------+------------------+-------------------+

**Technical Review Form**

You will be evaluated by the following selection criteria.

Please complete the following pages to the best of your ability.

1\. Curriculum Vitae 20 points

2\. International Experience 20 points

3\. Demonstrated Need 25 points

4\. Project plan and implementation 25 points

5\. References 10 points

Total 100 points

**Evaluation Criterion:** **Curriculum Vitae:** This section is worth 20
points.

1\. PLEASE INCLUDE A COPY OF YOUR Curriculum Vitae (C.V). Your c.v.
should contain the following pieces of information: current position,
previous experience, professional initiatives, honors, awards, and
involvement in educational/professional organizations, and impact in and
beyond the classroom. Please be sure to include your passport
information: Name as it appears on your passport, date of issue, date of
expiration, passport number, and place of issue. Please limit your CV to
no more than three pages. Any piece of the essay that exceeds the three
page limit will not be considered.

**Evaluation Criterion: International Experience:** This section is
worth 20 points.

2\. PLEASE COMMENT ON YOUR ABILITY TO LEARN FROM INTERNATIONAL AND/OR
INTERCULTURAL EXPERIENCES THAT YOU HAVE HAD. Please limit your essay to
no more than three pages. Any piece of the essay that exceeds the three
page limit will not be considered. (Relevant background includes travel,
formal study, demonstrated ability to adapt to/with new cultures- Does
not have to be an overseas experience.)

**Evaluation Criterion: Demonstrated Need:** This section is worth 25
points.

3**.** EXPLAIN YOUR NEED FOR THIS OVERSEAS EXPERIENCE AND WHY YOU WANT
TO PARTICIPATE IN THE SEMINAR (S) YOU SELECTED. Indicate why you require
greater knowledge of the host country (ies) by traveling overseas.
Include a discussion on what aspects of the society (ies) you are
interested in learning about. You must demonstrate a direct connection
between the seminar and your current teaching and/or administrative
responsibilities*.* Please limit your essay to no more than three pages.
Any piece of the essay that exceeds the three page limit will not be
considered.

**[Please Address All Country Choices]{.smallcaps}**

**Points will be deducted for not discussing countries listed on
Applicant Information Page**

**Evaluation Criterion:** **Project plan and implementation:** This
section is worth 25 points.

4**.** DESCRIBE HOW YOU PLAN TO INCORPORATE THE SEMINAR EXPERIENCE INTO
YOUR PROFESSIONAL WORK TO ENHANCE INTERNATIONAL, INTERCULTURAL
UNDERSTANDING. (such as teaching, curriculum development, and outreach
activities).

Please limit your essay to no more than three pages. Any piece of the
essay that exceeds the three page limit will not be considered.

######## Please Address All Country Choices

**Points will be deducted for not discussing countries listed on
Applicant Information Page**

**5. Reference Forms- Part 1**

**Evaluation Criterion: This section is worth 10 points.**

**Applicant Name:**

**First Country Choice:**

Suitability and adaptability for participation in a seminar abroad.

PART B-1. **SUPERVISOR REFERENCE FORM FOR APPLICANT**

Is the applicant a full time teacher, administrator, faculty, or staff
member? Yes ◊ No ◊

Please draft a letter responding to the following criteria for the
applicant:

Knowledge of specific field

Ability to work with colleagues, including those with differing views,
and or different backgrounds

Ability to communicate effectively

Adaptability

Leadership

Resourcefulness

Impact, in and beyond the classroom

Ability to work and travel in a group setting

Impression which will be made abroad as a U.S. citizen

Ability to exercise sound judgment

Additional comments on the applicants' professional competence,
experience, accomplishments, and personal qualities. Also, indicate any
limitations.

Please be sure to close the letter with your full contact information
and connection to the applicant.

Use Additional page if necessary.

[This Form is Subject to Release, ON REQUEST, to the
Applicant.]{.smallcaps}

**Reference Forms - Part 2**

**Applicant Name:**

**First Country Choice:**

**PART B-2. REFERENCE FORM FOR APPLICANT**

Please draft a letter responding to the following criteria for the
applicant:

Knowledge of specific field

Ability to work with colleagues, including those with differing views,
and or different backgrounds

Ability to communicate effectively

Adaptability

Leadership

Resourcefulness

Impact, in and beyond the classroom

Ability to work and travel in a group setting

Impression which will be made abroad as a U.S. citizen

Ability to exercise sound judgment

Please be sure to close the letter with your full contact information
and connection to the applicant.

Use additional page if necessary.

[This Form is Subject to Release, ON REQUEST, to the
Applicant]{.smallcaps}

**Reference Forms- Part 3**

**Applicant Name:**

**First Country Choice:**

**PART B-3. REFERENCE FORM FOR APPLICANT**

Please draft a letter responding to the following criteria for the
applicant:

Knowledge of specific field

Ability to work with colleagues, including those with differing views,
and or different backgrounds

Ability to communicate effectively

Adaptability

Leadership

Resourcefulness

Impact, in and beyond the classroom

Ability to work and travel in a group setting

Impression which will be made abroad as a U.S. citizen

Ability to exercise sound judgment

Please be sure to close the letter with your full contact information
and connection to the applicant.

Use additional page if necessary.

[This Form is Subject to Release, ON REQUEST, to the
Applicant.]{.smallcaps}

# CERTIFICATION REGARDING LOBBYING

Applicants must review the requirements for certification regarding
lobbying included in the regulations cited below before completing this
form. Applicants must sign this form to comply with the certification
requirements under 34 CFR Part 82, \"New Restrictions on Lobbying.\"
This certification is a material representation of fact upon which the
Department of Education relies when it makes a grant or enters into a
cooperative agreement.

As required by Section 1352, Title 31 of the U.S. Code, and implemented
at 34 CFR Part 82, for persons entering into a Federal contract, grant
or cooperative agreement over \$100,000, as defined at 34 CFR Part 82,
Sections 82.105 and 82.110, the applicant certifies that:

\(a\) No Federal appropriated funds have been paid or will be paid, by
or on behalf of the undersigned, to any person for influencing or
attempting to influence an officer or employee of any agency, a Member
of Congress, an officer or employee of Congress, or an employee of a
Member of Congress in connection with the making of any Federal grant,
the entering into of any cooperative agreement, and the extension,
continuation, renewal, amendment, or modification of any Federal grant
or cooperative agreement;

\(b\) If any funds other than Federal appropriated funds have been paid
or will be paid to any person for influencing or attempting to influence
an officer or employee of any agency, a Member of Congress, an officer
or employee of Congress, or an employee of a Member of Congress in
connection with this Federal grant or cooperative agreement, the
undersigned shall complete and submit Standard Form - LLL, \"Disclosure
Form to Report Lobbying,\" in accordance with its instructions;

\(c\) The undersigned shall require that the language of this
certification be included in the award documents for all subawards at
all tiers (including subgrants and contracts under grants and
cooperative agreements) and that all subrecipients shall certify and
disclose accordingly.

As the duly authorized representative of the applicant, I hereby certify
that the applicant will comply with the above certification.

  -----------------------------------------------------------------------
  NAME OF APPLICANT PR/AWARD NUMBER AND / OR PROJECT NAME

  PRINTED NAME AND TITLE OF AUTHORIZED REPRESENTATIVE

  SIGNATURE DATE
  -----------------------------------------------------------------------

ED 80-0013 06/04

**Certification Regarding Debarment, Suspension, Ineligibility and**

**Voluntary Exclusion \-- Lower Tier Covered Transactions**

This certification is required by the Department of Education
regulations implementing Executive Order 12549, Debarment and
Suspension, 34 CFR Part 85, for all lower tier transactions meeting the
threshold and tier requirements stated at Section 85.110.

**Instructions for Certification**

1\. By signing and submitting this proposal, the prospective lower tier
participant is providing the certification set out below.

2\. The certification in this clause is a material representation of
fact upon which reliance was placed when this transaction was entered
into. If it is later determined that the prospective lower tier
participant knowingly rendered an erroneous certification, in addition
to other remedies available to the Federal Government, the department or
agency with which this transaction originated may pursue available
remedies, including suspension and/or debarment.

3\. The prospective lower tier participant shall provide immediate
written notice to the person to which this proposal is submitted if at
any time the prospective lower tier participant learns that its
certification was erroneous when submitted or has become erroneous by
reason of changed circumstances.

4\. The terms \"covered transaction,\" \"debarred,\" \"suspended,\"
\"ineligible,\" \"lower tier covered transaction,\" \"participant,\" \"
person,\" \"primary covered transaction,\" \" principal,\" \"proposal,\"
and \"voluntarily excluded,\" as used in this clause, have the meanings
set out in the Definitions and Coverage sections of rules implementing
Executive Order 12549. You may contact the person to which this proposal
is submitted for assistance in obtaining a copy of those regulations.

5\. The prospective lower tier participant agrees by submitting this
proposal that, should the proposed covered transaction be entered into,
it shall not knowingly enter into any lower tier covered transaction
with a person who is debarred, suspended, declared ineligible, or
voluntarily excluded from participation in this covered transaction,
unless authorized by the department or agency with which this
transaction originated.

6\. The prospective lower tier participant further agrees by submitting
this proposal that it will include the clause titled Certification
Regarding Debarment, Suspension, Ineligibility, and Voluntary
Exclusion-Lower Tier Covered Transactions, without modification, in all
lower tier covered transactions and in all solicitations for lower tier
covered transactions.

7\. A participant in a covered transaction may rely upon a certification
of a prospective participant in a lower tier covered transaction that it
is not debarred, suspended, ineligible, or voluntarily excluded from the
covered transaction, unless it knows that the certification is
erroneous. A participant may decide the method and frequency by which it
determines the eligibility of its principals. Each participant may but
is not required to, check the Nonprocurement List.

8\. Nothing contained in the foregoing shall be construed to require
establishment of a system of records in order to render in good faith
the certification required by this clause. The knowledge and information
of a participant is not required to exceed that which is normally
possessed by a prudent person in the ordinary course of business
dealings.

9\. Except for transactions authorized under paragraph 5 of these
instructions, if a participant in a covered transaction knowingly enters
into a lower tier covered transaction with a person who is suspended,
debarred, ineligible, or voluntarily excluded from participation in this
transaction, in addition to other remedies available to the Federal
Government, the department or agency with which this transaction
originated may pursue available remedies, including suspension and/or
debarment.

**Certification**

\(1\) The prospective lower tier participant certifies, by submission of
this proposal, that neither it nor its principals are presently
debarred, suspended, proposed for debarment, declared ineligible, or
voluntarily excluded from participation in this transaction by any
Federal department or agency.

\(2\) Where the prospective lower tier participant is unable to certify
to any of the statements in this certification, such prospective
participant shall attach an explanation to this proposal.

ED 80-0014, 9/90

**ASSURANCES - NON-CONSTRUCTION PROGRAMS**

**OMB Approval No. 0348-0040**

Public reporting burden for this collection of information is estimated
to average 15 minutes per response, including time for reviewing
instructions, searching existing data sources, gathering and maintaining
the data needed, and completing and reviewing the collection of
information. Send comments regarding the burden estimate or any other
aspect of this collection of information, including suggestions for
reducing this burden, to the Office of Management and Budget, Paperwork
Reduction Project (0348-0040), Washington, DC 20503.

**PLEASE DO NOT RETURN YOUR COMPLETED FORM TO THE OFFICE OF MANAGEMENT
AND BUDGET. SEND IT TO THE ADDRESS PROVIDED BY THE SPONSORING AGENCY.**

**Note:** Certain of these assurances may not be applicable to your
project or program. If you have questions, please contact the awarding
agency. Further, certain Federal awarding agencies may require
applicants to certify to additional assurances. If such is the case, you
will be notified.

As the duly authorized representative of the applicant I certify that
the applicant:

1\. Has the legal authority to apply for Federal assistance, and the
institutional, managerial and financial capability (including funds
sufficient to pay the non-Federal share of project cost) to ensure
proper planning, management, and completion of the project described in
this application.

2\. Will give the awarding agency, the Comptroller General of the United
States, and if appropriate, the State, through any authorized
representative, access to and the right to examine all records, books,
papers, or documents related to the award; and will establish a proper
accounting system in accordance with generally accepted accounting
standards or agency directives.

3\. Will establish safeguards to prohibit employees from using their
positions for a purpose that constitutes or presents the appearance of
personal or organizational conflict of interest, or personal gain.

4\. Will initiate and complete the work within the applicable time frame
after receipt of approval of the awarding agency.

5\. Will comply with the Intergovernmental Personnel Act of 1970 (42
U.S.C. 4728-4763) relating to prescribed standards for merit systems
for programs funded under one of the 19 statutes or regulations
specified in Appendix A of OPM\'s Standards for a Merit System of
Personnel Administration (5 C.F.R. 900, Subpart F).

6\. Will comply with all Federal statutes relating to nondiscrimination.
These include but are not limited to: (a) Title VI of the Civil Rights
Act of 1964 (P.L. 88-352) which prohibits discrimination on the basis of
race, color or national origin; (b) Title IX of the Education Amendments
of 1972, as amended (20 U.S.C. 1681-1683, and 1685-1686), which
prohibits discrimination on the basis of sex; (c) Section 504 of the
Rehabilitation Act of 1973, as amended (29 U.S.C. 794), which prohibits
discrimination on the basis of handicaps; (d) the Age Discrimination Act
of 1975, as amended (42 U.S.C.  6101-6107), which prohibits
discrimination on the basis of age; (e) the Drug Abuse Office and
Treatment Act of 1972 (P.L. 92-255), as amended, relating to
nondiscrimination on the basis of drug abuse; (f) the Comprehensive
Alcohol Abuse and Alcoholism Prevention, Treatment and Rehabilitation
Act of 1970 (P.L. 91-616), as amended, relating to nondiscrimination on
the basis of alcohol abuse or alcoholism; (g)  523 and 527 of the
Public Health Service Act of 1912 (42 U.S.C.  290 dd-3 and 290 ee 3),
as amended, relating to confidentiality of alcohol and drug abuse
patient records; (h) Title VIII of the Civil Rights Act of 1968 (42
U.S.C.  3601 et seq.), as amended, relating to nondiscrimination in the
sale, rental or financing of housing; (i) any other nondiscrimination
provisions in the specific statute(s) under which application for
Federal assistance is being made; and (j) the requirements of any other
nondiscrimination statute(s) which may apply to the application.

7\. Will comply, or has already complied, with the requirements of
Titles II and III of the uniform Relocation Assistance and Real Property
Acquisition Policies Act of 1970 (P.L. 91-646) which provide for fair
and equitable treatment of persons displaced or whose property is
acquired as a result of Federal or federally assisted programs. These
requirements apply to all interests in real property acquired for
project purposes regardless of Federal participation in purchases.

8\. Will comply, as applicable, with the provisions of the Hatch Act (5
U.S.C. 1501-1508 and 7324-7328) which limit the political activities
of employees whose principal employment activities are funded in whole
or in part with Federal fun

9\. Will comply, as applicable, with the provisions of the Davis-Bacon
Act (40 U.S.C. 276a to 276a-7), the

Copeland Act (40 U.S.C. 276c and 18 U.S.C. 874) and the Contract Work
Hours and Safety Standards

Act (40 U.S.C.  327-333), regarding labor standards for federally
assisted construction subagreements.

10\. Will comply, if applicable, with flood insurance purchase
requirements of Section 102(a) of the Flood Disaster Protection Act of
1973 (P.L. 93-234) which requires recipients in a special flood hazard
area to participate in the program and to purchase flood insurance if
the total cost of insurable construction and acquisition is \$10,000 or
more.

11\. Will comply with environmental standards which may be prescribed
pursuant to the following: (a) institution of environmental quality
control measures under the National Environmental Policy Act of 1969
(P.L. 91-190) and Executive Order (EO) 11514; (b) notification of
violating facilities pursuant to EO 11738; (c) protection of wetlands
pursuant to EO 11990; (d) evaluation of flood hazards in floodplains in
accordance with EO 11988; (e) assurance of project consistency with the
approved State management program developed under the Coastal Zone
Management Act of 1972 (16 U.S.C. 1451 et seq.); (f) conformity of
Federal actions to State (Clear Air) Implementation Plans under Section
176(c) of the Clear Air Act of 1955, as amended (42 U.S.C. 7401 et
seq.); (g) protection of underground sources of drinking water under the
Safe Drinking Water Act of 1974, as amended, (P.L. 93-523); and (h)
protection of endangered species under the Endangered Species Act of
1973, as amended, (P.L. 93-205).

12 Will comply with the Wild and Scenic Rivers Act of 1968 (16 U.S.C.
1721 et seq.) related to protecting components or potential components
of the national wild and scenic rivers system.

13\. Will assist the awarding agency in assuring compliance with Section
106 of the National Historic Preservation Act of 1966, as amended (16
U.S.C. 470), EO 11593 (identification and protection of historic
properties), and the Archaeological and Historic Preservation Act of
1974 (16 U.S.C. 469a-1 et seq.).

14\. Will comply with P.L. 93-348 regarding the protection of human
subjects involved in research, development, and related activities
supported by this award of assistance.

15\. Will comply with the Laboratory Animal Welfare Act of 1966 (P.L.
89-544, as amended, 7 U.S.C. 2131 et seq.) pertaining to the care,
handling, and treatment of warm blooded animals held for research,
teaching, or other activities supported by this award of assistance.

16\. Will comply with the Lead-Based Paint Poisoning Prevention Act (42
U.S.C. 4801 et seq.) which prohibits the use of lead- based paint in
construction or rehabilitation of residence structures.

17\. Will cause to be performed the required financial and compliance
audits in accordance with the Single Audit Act Amendments of 1996 and
OMB Circular No. A-133, Audits of States, Local Governments, and
Non-Profit Organizations.

18\. Will comply with all applicable requirements of all other Federal
laws, executive orders, regulations and policies governing this program.

**Standard Form 424B (Rev. 7-97) Back**

+-----------------------------------------------------------------------+
| ![](media/image2.png){width="1.0694444444444444in"                    |
| height="0.9159722222222222in"}                                        |
|                                                                       |
| **Certification of eligibility for federal assistance in certain      |
| programs**                                                            |
|                                                                       |
| I understand that 34 CFR 75.60, 75.61, and 75.62 require that I make  |
| specific certifications of eligibility to the U.S. Department of      |
| Education as a condition of applying for Federal funds in certain     |
| programs and that these requirements are in addition to any other     |
| eligibility requirements that the U.S. Department of Education        |
| imposes under program regulations. Under 34 CFR 75.60 -- 75.62:       |
|                                                                       |
| I.  I certify that                                                    |
|                                                                       |
| ```{=html}                                                            |
| <!-- -->                                                              |
| ```                                                                   |
| A.  I do not owe a debt, or I am current in repaying a debt, or I am  |
|     not in default (as that term is used at 34 CFR Part 668) on a     |
|     debt:                                                             |
|                                                                       |
| ```{=html}                                                            |
| <!-- -->                                                              |
| ```                                                                   |
| 1.  To the Federal Government under a nonprocurement transaction      |
|     (e.g., a previous loan, scholarship, grant, or cooperative        |
|     agreement); or                                                    |
|                                                                       |
| 2.  For a fellowship, scholarship, stipend, discretionary grant, or   |
|     loan in any program of the U.S. Department of Education that is   |
|     subject to 34 CFR 75.60, 75.61, and 75.62, including:             |
|                                                                       |
| -   Federal Pell Grant Program (20 U.S.C. 1070a, et seq.);            |
|                                                                       |
| -   Federal Supplemental Educational Opportunity Grant (SEOG) Program |
|     (20 U.S.C. 1070(b), et seq.):                                     |
|                                                                       |
| -   State Student Incentive Grant Program (SSIG) 20 U.S.C. 1070c, et  |
|     seq.);                                                            |
|                                                                       |
| -   Federal Perkins Loan Program (20 U.S.C. 1087aa, et seq.);         |
|                                                                       |
| -   Income Contingent Direct Loan Demonstration Project (20 U.S.C.    |
|     1087a, note);                                                     |
|                                                                       |
| -   Federal Stafford Loan Program, Federal Supplemental Loans for     |
|     Students \[SLS\], Federal PLUS, or Federal Consolidation Loan     |
|     Program (20 U.S.C. 1071, et seq.);                                |
|                                                                       |
| -   Cuban Student Loan Program (20 U.S.C. 2601, et seq.);             |
|                                                                       |
| -   Robert C. Byrd Honors Scholarship Program (20 U.S.C. 1070d-31, et |
|     seq.);                                                            |
|                                                                       |
| -   Jacob K. Javits Fellows Program (20 U.S.C. 1134h-1134l);          |
|                                                                       |
| -   Patricia Roberts Harris Fellowship Program (20 U.S.C.             |
|     1134d-1134g);                                                     |
|                                                                       |
| -   Christa McAuliffe Fellowship Program (20 U.S.C. 1105-1105I);      |
|                                                                       |
| -   Bilingual Education Fellowship Program (20 U.S.C. 3221-3262);     |
|                                                                       |
| -   Rehabilitation Long-Term Training Program (29 U.S.C. 774(b));     |
|                                                                       |
| -   Paul Douglas Teacher Scholarship (20 U.S.C. 1104, et seq.);       |
|                                                                       |
| -   Law Enforcement Education Program (42 U.S.C. 3775);               |
|                                                                       |
| -   Indian Fellowship Program (29 U.S.C. 774(b));                     |
|                                                                       |
| # OR                                                                  |
|                                                                       |
| B.  I have made arrangements satisfactory to the U.S. Department of   |
|     Education to repay a debt as described in A.1. or A.2. (above) on |
|     which I had not been current in repaying or on which I was in     |
|     default (as that term is used in 34 CFR Part 668).                |
|                                                                       |
| ```{=html}                                                            |
| <!-- -->                                                              |
| ```                                                                   |
| II. I certify also that I have not been declared by a judge, as a     |
|     condition of sentencing under section 5301 of the Anti-Drug Abuse |
|     Act of 1988 (21 U.S.C. 862), ineligible to receive Federal        |
|     assistance for the period of this requested funding.              |
|                                                                       |
| I understand that providing a false certification to any of the       |
| statements above makes me liable for repayment to the U.S. Department |
| of Education for funds received on the basis of this certification,   |
| for civil penalties, and for criminal prosecution under 18 U.S.C.     |
| 1001.                                                                 |
|                                                                       |
| Name or number of the usde program under which this certification is  |
| being made: **[FULBRIGHT-HAYS SEMINARS ABROAD PROGRAM, CFDA NO.       |
| 84.018]{.underline}**                                                 |
+-----------------------------------------------------------------------+

ED 80-0016 (Revised 12/96)

**The Government Performance and Results Act (GPRA)**

**What is GPRA?**

The Government Performance and Results Act of 1993 (GPRA) is a
straightforward statute that requires all federal agencies to manage
their activities with attention to the consequences of those activities.
Each agency is to clearly state what it intends to accomplish, identify
the resources required, and periodically report their progress to the
Congress. In so doing, it is expected that the GPRA will contribute to
improvements in accountability for the expenditures of public funds,
improve congressional decision-making through more objective information
on the effectiveness of federal programs, and promote a new government
focus on results, service delivery, and customer satisfaction.

**How has the Department of Education Responded to the GPRA
Requirements?**

As required by GPRA, the Department of Education has prepared a
strategic plan for 2002-2007. This plan reflects the Department's
priorities and integrates them with its mission and program authorities
and describes how the Department will work to improve education for all
children and adults in the United States. The Department's goals, as
listed in the plan, are:

Goal 1: Create a Culture of Achievement

Goal 2: Improve Student Achievement

Goal 3: Develop Safe Schools and Strong Character

Goal 4: Transform Education into an Evidence-based Field

Goal 5: Enhance the Quality of and Access to Postsecondary and Adult
Education

Goal 6: Establish Management Excellence

The performance indicators for the International Education Programs are
part of the Department's plan for meeting Goal 5: Enhance the Quality of
and Access to Postsecondary and Adult Education.

**What are the Performance Indicators for the International Education
Programs?**

The Department's specific goal for the International Education programs
is \"to meet the nation\'s security and economic needs through the
development and maintenance of a national capacity in foreign languages,
and area and international studies." The Department has established
objectives and performance indicators for the Title VI and Fulbright
Hays programs and data are collected through the Evaluation of Exchange,
Language, Area and International Studies (EELIAS) performance reporting
system. The indicators for the International Education programs focus on
the following areas: (1) expansion of critical languages; (2) employment
in field; and (3) improved language competency.

All grantees are required to submit annual performance reports through
EELIAS that describe the projects\' accomplishments and provide GPRA
data. Data collected from each of the fourteen International Education
programs are used to assess the success of meeting the performance
objectives.

IMPORTANT NOTICE TO PROSPECTIVE PARTICIPANTS

**IN U.S. DEPARTMENT OF EDUCATION**

**GRANT AND CONTRACT PROGRAMS**

GRANTS

Applicants for grants from the U.S. Department of Education (ED) have to
compete for limited funds. Deadlines assure all applicants that they
will be treated fairly and equally, without last minute haste. For these
reasons, ED must set strict deadlines for grant applications.
Prospective applicants can avoid disappointment if they understand that:

**Failure to meet a deadline will mean that an applicant will be
rejected without any consideration.**

The rules, including the deadline, for applying for each grant are
published, individually, in the Federal Register. A one-year
subscription to the Register may be obtained by sending \$555.00 to:
Superintendent of Documents, U.S. Government Printing Office,
Washington, D.C. 20402-9371. (Send check or money order only, no cash or
stamps.) In addition, the Federal Register is available on-line for free
on Government Printing Office (GPO) Access:
[http://www.access.gpo.gov/nara]{.underline}. Depository Library
location and Federal Register services:
[http://www.nara.gov/fedreg]{.underline}.

The instructions in the Federal Register must be followed exactly. Do
not accept any other advice you may receive. No ED employee is
authorized to extend any deadline published in the Register. No ED
employees are authorized to extend any deadline published in the Federal
Register. Questions regarding submission of applications may be
addressed to:

U.S. Department of Education

Application Control Center

Washington, DC 20202-4260

CONTRACTS

Competitive procurement actions undertaken by the ED are governed by the
Federal Acquisition Regulations and implementing Department of Education
Acquisition Regulations.

Generally, prospective competitive procurement actions are synopsized in
the Commerce Business Daily (CBD). Prospective offerors are therein
advised of the nature of the procurement and where to apply for copies
of the Request for Proposals (RFP). All of ED's RFP's are now available
on-line for downloading at the following url:
[http://www.ed.gov/offices/ocfo/contracts/currrfp.html]{.underline}.

Offerors are advised to be guided solely by the contents of the CBD
synopsis and the instructions contained in the RFP. Questions regarding
the submission of offers should be addressed to the Contracts Specialist
identified on the face page of the RFP. Offers are judged in competition
with others, and failure to conform with any substantive requirements of
the RFP will result in rejection of the offer without any consideration
whatever.

Do not accept any advice you receive that is contrary to instructions
contained in either the CBD synopsis or the RFP. No ED employee is
authorized to consider a proposal which is non-responsive to the RFP. A
subscription to the CBD is available for \$208.00 per year via second
class mailing or \$261.00 per year via first class mailing. Information
included in the Federal Acquisition Regulation is contained in Title 48,
Code of Federal Regulations, Chapter 1 (\$49.00). The foregoing
publication may be obtained by sending your check or money order only,
no cash or stamps, to:

Superintendent of Documents

U.S. Government Printing Office

Washington, DC 20402-9371

In addition, the Commerce Business Daily is available on-line for free
at the following url: [http://cbdnet.access.gpo.gov/]{.underline}. The
Federal Acquisition Regulations are available on-line at the following
url: [http://www.arnet.gov/far/]{.underline}. In an effort to be certain
this important information is widely disseminated, this notice is being
included in all ED mail to the public. You may therefore, receive more
than one notice. If you do, we apologize for any annoyance it may cause
you.

ED FORM 5348, 7/01

**2009 FULBRIGHT-HAYS SEMINARS ABROAD PROGRAM**

#### **TERMS AND CONDITIONS OF THE AWARD**

Participants in the Seminars Abroad Program must comply with all terms
and conditions of the award and directions from program staff. If a
participant fails to comply with these terms and conditions and any
additional directions, the U.S. Department of Education may terminate
the grant, require the participant to repay the government for any funds
spent to support the participant or bar the participant from any future
seminars.

By accepting this award, the participant agrees to comply with all laws
of the United States and the host country.

The participant agrees not to engage in any activities that are likely
to give offense to the host country or to bring the United States into
disrepute.

By accepting this award, the participant agrees to attend and
participate in all seminar activities.

          Seminar activities are very intensive and *attendance at all
activities is required*. Being joined by dependents, relatives, or
friends in the host country during the period of the seminar is not
permitted 

         By accepting this award, the participant is agreeing that
he/she is willing to endure certain discomforts that may arise, and that
he or she is able to keep up with the high pace of the program.

         The candidate must be physically and psychologically able to
participate in all phases of the seminar. Award recipients must provide
a physician's statement to reflect participants' readiness for travel

         Participants are required to contribute \$400.00 as a cost
share to help defer the costs of the seminar program*.*

         Participants are responsible for additional expenses which may
include the following: **♦**passport and visa fees; ♦inoculations; ♦the
purchasing of gifts to bring for any visits during the seminar; ♦charges
for telephone calls and/or faxing to the overseas administering agency
during the pre-departure period; ♦the purchasing of books/curriculum
materials during the seminar; and ♦personal expenditures.

         All seminar participants are required to have health insurance
that is valid in the host country (ies). The participant's insurance
**must include emergency evacuation and repatriation of remains
coverage.** If participant's current health insurance is not valid, he
ore she is required to purchase insurance through the United States
Department of State (DOS) or some other group carrier.

 Participants are required to notify our office of any change in their
physical or mental health

prior to the beginning of the seminar.

         Participants are **required** to complete one curriculum
project that is relevant to institutions' use. The project will be
facilitated by the U.S. Department of Education's administering agency
in the host country (ies), and is due within 90 days of the seminar end
date.

         Participants are required to share their curriculum projects
with colleagues and conduct outreach activities in their schools,
institutions, and communities upon return to the U.S. (Participants will
be asked to submit a detailed dissemination report on how this was
accomplished.)

         Participants are required to complete an evaluation of the
seminar using a form provided by the U.S. Department of Education.

         Travel must be taken in accordance with the ticket issued by
the overseas administering agency.

         All announced seminars are subject to the availability of
Federal funds and the cooperation of foreign nations. Seminars could be
cancelled or changed due to a decrease in funding, situations in the
host countries, or too few applications received.

**[THE J. WILLIAM FULBRIGHT FOREIGN SCHOLARSHIP BOARD]{.underline}**

**[STATEMENT OF THE RIGHTS AND RESPONSIBILITIES OF AMERICAN
GRANTEES]{.underline}**

"Grants under the Mutual Educational and Cultural Exchange Act of 1961,
as amended (Fulbright-Hays Act), involve certain obligations and
responsibilities on the part of each grantee. A person accepting such a
grant is not by virtue thereof an official or employee of the Department
of State or other agency of the Government of the United States of
America, or of an agency of the government of the host country.

Grantees are private citizens, retaining the rights of citizens to the
personal and intellectual freedom generally accepted under the United
States constitutional system and by the educational community.

The J. William Fulbright Foreign Scholarship Board believes, however,
the individual grantees are responsible for protecting the nonpolitical
character of the program during their grants. They should be aware that
their public political statements or activity while abroad may, in
certain circumstances, draw into the political arena an educational
exchange program that has been characterized since its inception, as
free and nonpolitical.

Further, it should be recognized that American citizens who make
political statements abroad or who engage in activities with political
connotations may thereby become involved in the domestic political
processes of their host country even when they wish only to express
agreement or disagreement with U.S. Government policy. Grantees should
be aware that such activities are incompatible with the objectives of
the program and that they are responsible for exercising discretion and
judgment in all of their actions, both public and private."

**[REVOCATION OR TERMINATION OF THE AWARD]{.underline}**

Upon the recommendation of the bi-national commission, overseas posts,
and the Secretary of Education, the J. William Fulbright Foreign
Scholarship Board may terminate your award.

"Grounds for revocation may include but are not limited to: (1)
violations of the laws of the United States or of the host country; (2)
misconduct; (3) failure to observe satisfactory academic or professional
standards; (4) physical or mental incapacitation; (5) acts likely to
give offense to the host country; and/or (6) engaging in political or
unauthorized income-producing activities; or other activities which in
the discretion of the Foreign Scholarships Board and the Department are
inconsistent with the best interests of the program."

**[CERTIFICATION]{.underline}**

I certify that the information I provided on this application is correct
to the best of my ability and that I agree to the terms and conditions
of the award if selected.

> Signature of Applicant Date

**INFORMATION ON THE PRIVACY ACT**

In accordance with the Privacy Act of 1974 (Public Law No. 93-579, 5
U.S.C. 552a), you are hereby notified that: (l) The Department is
authorized to collect information to implement the Fulbright-Hays
Seminars Abroad Program/Bilateral Projects under the Mutual Educational
and Cultural Exchange Act of 1961 (Public Law 87-256; 75 Stat. 527) and
Section 4 of Executive Order 11034. In accordance with this authority,
the Office receives and maintains personal information on applicants for
use in processing applications and selecting participants. (2) The
principle purpose for collecting this information is to administer the
program, including use by program staff and field readers to determine
eligibility and suitability for participation in a seminar abroad and
use by program staff to ensure compliance with program requirements. (3)
The information may be disclosed to third parties such as the U.S.
embassies, agencies that the Department has authorized to assist in
administering the seminars including binational commissions, the J.
William Fulbright Foreign Scholarship Board, and in some cases foreign
governments for use in issuing visas.

Disclosure may be made to a Congressional office from the record of an
individual in response to an inquiry from the Congressional office made
at the request of that individual. If the Department or an employee of
the Department is involved in litigation, the Department may send your
information to the Department of Justice, a court, adjudicative body, or
potential witness provided such disclosure is compatible with the
purpose for which the information was requested. Disclosure may also be
made to the Department of Justice for the purpose of obtaining its
advice as to whether particular records are required to be disclosed
under the Freedom of Information Act. When the appropriate office of Ed
determines that an individual or an organization is qualified to carry
out specific research, that official may disclose information to that
researcher solely for the purpose of carrying out the research. When ED
contracts with a private firm for the purpose of administering the
seminar(s), relevant records will be disclosed to the contractor. The
contractor shall by required to maintain Privacy Act safeguards with
respect to such records. Information may be disclosed to any Federal,
State, local or foreign agency or public authority responsible for
enforcing, investigating, or prosecuting violations of administrative,
civil, or criminal law or regulation where the information is relevant
to any enforcement, regulatory, investigative, or prosecutive
responsibility with the receiving entity's jurisdiction. Information may
be disclosed in response to a subpoena issued by a Federal agency having
the power to subpoena records or other Federal agencies. (4) You are not
required to submit the information requested in this application,
however the information will be used in the processing and evaluation of
applications; and the effects of not providing all or any part of the
requested information may delay the process or make it impossible to
process an application (disclosure of your social security number is
voluntary; failure to disclose such a number will not result in the
denial of any right, benefit or privilege to which an individual is
entitled).