application form

							                     WOMEN’S LEADERSHIP
                    TRAINING IN ECONOMICS

                                APPLICATION FORM

1. Full name (Last, First, Middle Initial):

2. Date of birth (mm/dd/yyyy):

3. Sex:    M           F

4. E-mail address (one address only)

5. Permanent home address:

6. Telephone:

7. Mailing address (if different):



8. Nationality:

9. Country of birth:

10. Please check to ensure that you meet the following requirements and tick to indicate
that you have done so. If you are not sure if your qualifications match those we require,
or if your results are borderline, you should apply anyway, and your application will be
considered on its merits.

         I am a female Vietnamese citizen

         I have an undergraduate degree in economics or a related field

         I have three years (or more) of work experience in related areas

         I have a valid minimum TOEFL score of 550 (International or
          Institutional) equivalent to 79 (iBT) or IELTS 6.5
      I am/was employed in the Vietnamese government with aspiration for
       future government/public sector services

      I have not earned a Bachelor’s or Master’s degree from a U.S. college
       or university within the last three years

11. Please state the full title of the Master’s program you would like to pursue (This
choice is not final. More information will become available if you are selected).


12. Have you ever applied for a USG-funded scholarship before? When and where?



13. Qualifications held (attach separate sheet if necessary)
Please give your academic history to date.

    Name of              Years        Degree awarded             Major          Grade in the
University/College      attended      (e.g., Bachelor     (e.g., Economics)       standard
  and Address                           or Master's)                           format of your
                                                                                degree (e.g.,
                                                                                  BA GPA
                                                                               3.7/4.0, A+ or
                                                                                90%, 8.5/10)
15. English language proficiency

I took/will take the language test on       Day                Month              Year

Type of test taken (e.g., TOEFL):

Test score                                  Listening       Writing     Reading   Speaking
                                                                                  (if applicable)

Total score


16. GRE/GMAT

I took/will take GRE/GMAT on                      Day                 Month           Year

Test score                                      Verbal          Quantitative       Analytical
                                                                                    Writing

Total score


17. Employment history (attach separate sheet if necessary)
Please give us your employment history or other professional history to date. Include
internships, if relevant.

    Dates (from and to)                  Nature of work                   Name, address, and
 (e.g., 10/2006 – 11/2007)              and position held               telephone of employer




18. Academic interests and purpose of study
Please attach a personal statement in English that describes your academic interests and
your purpose and objectives in undertaking graduate study in Economics. This is your
opportunity to introduce yourself to the selectors. Please describe your past training and
experience and how these prepare your for a graduate degree in economics. Indicate
whether there are particular areas of study you wish to focus on in your degree. Explain
how you plan to use this degree in Vietnam once you return. Your statement should be no
longer than 1,000 words.

19. References
Please give the names of your three references and provide their letters of reference.

    Name         Position          Institution           Email            Telephone
                                                        Address            number




An offer of participation in this program is valid only if made in writing from the U.S.
Agency for International Development (USAID). Statements made over the telephone or
e-mail are always subject to confirmation and are never binding on USAID or the United
States Government.

Before signing this form please ensure that you have completed all questions and
included all required supporting documents with your application.


Signature ___________________________________ Date ________________________

U.S. Agency for International Development (USAID)
Vietnam Mission
15/F Tung Shing Square
#2 Ngo Quyen Street, Hanoi, Vietnam
Tel: (84-4) 3935-1260
Fax: (84-4) 3935-1265