Application Format:

Please submit your application no later than Sunday, October 19, 2008.
It is essential that all items are included and completely accurate.

A. Applicant's full name, exactly as it appears in his/her passport (or national identity document). Clearly identify first, middle and surnames as they appear in passport/ID.

First Middle Last

B. Date of Birth (please spell out Month, Day, Year)

Month Day Year

C. City/State of Birth

City State

D. Country of Birth

E. Country of Residence

F. Country(ies) of Citizenship

G. Home Address, Telephone and E-mail

Address City

State CEP

DDD Telephone E-mail

H. Gender

I. Medical, Physical, Dietary or other Personal Considerations: Please state any existing medical conditions or if you are currently taking any prescription medication. (This will not affect selection, but will enable the host institution to make any necessary accommodations.)

J. Name, city, state of your University

a) University State City

b) University State City

K. Field of Study

a)
b)

L. Education, Academic and Professional Training

M. Active Memberships

N. Special Interests

O. Extracurricular Activities (Volunteer work, community service...)

P. Previous Experience in the United States: Please list any and all trips
to the United States and include approximate dates and the reason for travel.

Q. Family Residing in the United States: Please list any immediate family members
who are currently residing in the United States, including city and state.

R. Evidence of English Fluency: Please attach one of the following:

1) TOEFL score and testing date (you do not need to take the TOEFL;
only for applicants who have already taken a TOEFL exam);

Score Certificate (Formats JPEG, PDF or DOC)

2) TELP score (Click here for testing centers);

Score Certificate (Formats JPEG, PDF or DOC)

3) Other:

I have studied at an institution where English was the primary
language of instruction. Where?

I live more than 300 kilometers from a testing center.

I do not have evidence of proficiency in English, but I feel I have the required level of English ability for this program. Justify

NOTE: If you have any supporting documents for the above items, please attach them here:

(Only files in formats JPEG, PDF or DOC, not larger than 1 Mb)

S. Future study or career plans

T. Personal Statement (no more than one page)

U. Official copy of your most recent university transcript: Please attach a scanned copy (in Portuguese, thers is no need to have it translated).

(Only files in formats JPEG, PDF or DOC, not larger than 1 Mb)

V. How did you find out about this program?

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