Wufoo

Background Information
Name * First Last
Address *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Phone Number *

If you are applying from within the United States, please include your area code. If you are applying from outside the United States, specify your country code.
Email *
Vittana User Email

If your Vittana user login email differs from your email above, let us know.
Skype Name *

Skype is an essential form of communication both within Vittana and with our partners. Enter your name here.
Twitter Username

Please enter your Twitter username here if you have one.
Personal Blog

We would love to hear more about your interest and what is on your mind. If you have a blog and would like to share it with us, please provide the link here.
Are you age 21 or over? *

We prefer that all applicants are at least 21.
Fellowship Preferences
Regional Preference *
Africa Asia Latin America Middle East/North Africa No Preference

If you were to be accepted as a Vittana Fellow, to what area of the world would you like to go?

Please note that placements in Latin America require Spanish skills at professional working proficiency or above.
Quarter of Desired Departure *
Ideal Start Date * MM / DD / YYYY
What is the first date you are available?
End of Availability * MM / DD / YYYY
This is the end of the period you are available to travel. If your end date is fluid, please provide your best estimate.
Preferred length of trip *

Be honest about what amount of time you have to devote to being a Vittana Fellow. Strong preference will be given to lengths of 4 months or more.
Referral Source *

How did you hear about the Vittana Fellowship?
Other:

If you selected other above, please let us know where you heard about the Fellowship.
Education
Highest Degree Earned *
Education Institution *

What is the name of the school where you earned that degree?
Education Institution City *

Where did you earn your highest degree?
Education Institution State *

Where did you earn your highest degree?
International Experience

I have... *
	Less than 1 month	1-3 months	4-6 months	6-12 months	1-2 years	More than 2 years	N/A
worked/lived abroad in a developed country	1	2	3	4	5	6	-
worked/lived abroad in a developing country	1	2	3	4	5	6	-
studied abroad in a developed country	1	2	3	4	5	6	-
studied abroad in developing country	1	2	3	4	5	6	-
traveled abroad alone	1	2	3	4	5	6	-
traveled abroad in a group	1	2	3	4	5	6	-
volunteered abroad	1	2	3	4	5	6	-

Please tell us more about your experience abroad. *

In which country/ies have you spent significant time? Which experience noted above was most impactful?

In which languages below, if any, do you have proficiency?
	Elementary proficiency	Limited working proficiency	Professional working proficiency	Full professional proficiency	Native/bilingual proficiency
Spanish	1	2	3	4	5
Arabic	1	2	3	4	5
Vietnamese	1	2	3	4	5
Khmer	1	2	3	4	5
Bahasa Indonesia	1	2	3	4	5
Filipino dialects	1	2	3	4	5
French	1	2	3	4	5
English	1	2	3	4	5
Other	1	2	3	4	5

Professional Experience
Our Vittana Fellows are resilient, adaptive, and proactive. Please tell us about a challenging professional experience and describe what you did to succeed. (250 words) *
Cover Letter *

Your cover letter should explain why you would like to be a Vittana Fellow and how your previous experience has prepared you to become a Fellow. Please UPLOAD a copy of your cover letter to a hosting service like Google Docs or Microsoft Live Workspace and put the link to it here. Do not create a new document. Set the sharing settings so ANYONE WITH THE LINK can view.
Resume/CV *

Please UPLOAD a copy of your resume to a hosting service like Google Docs or Microsoft Live Workspace and put the link to it here. DO NOT create a new document. Set the sharing settings so ANYONE WITH THE LINK can view.
References *

Please UPLOAD a copy of your references listing name, relationship, and contact information to a hosting service like Google Docs or Microsoft Live Workspace and put the link to it here. DO NOT create a new document. Set the sharing settings so ANYONE WITH THE LINK can view.
Do Not Fill This Out

Wufoo

Background Information

Fellowship Preferences

Education

International Experience

Professional Experience