Coordinate Research Program
Return to: Coordinate Research Program Harvard-Yenching Institute Vanserg Hall, Suite 20 25 Francis Avenue Cambridge, MA 02138 USA
: Annual Deadlines for Applications April 15 and October 15
Email: yenching@fas.harvard.edu Fax: 617-496-7206 Website: http://www.harvard-yenching.org
PART ONE (to be completed by faculty member/researcher applying) Please type or write in black ink. 1. Family Name __________________________ Given Name _________________________________________ Gender (please check): Male Female
漢字 ____________________________ Age ___________
2. Place of Birth: City ___________ Country ________________ Date of Birth _________________________________ 3. Citizenship (nation from which passport is obtained) _____________________________________________________ 4. Present title as faculty member ______________________________________________________________________ 5. University and Department: _________________________________________________________________________ 6. Office address____________________________________________________________________________________ 7. Telephone: Office___________________________________ 8. Fax: _______________________________________ 9. Email: _____________________________________ 10. Best Mailing Address: ____________________________________________________________________________ 11. Colleges & Universities Attended ___________________________ ___________________________ ___________________________ ___________________________ Principal subject ________________ ________________ ________________ ________________ Dates of study _____________ _____________ _____________ _____________ Degree & year awarded ___________________ ___________________ ___________________ ___________________ Home_______________________________________
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12. Names, addresses, phone/fax numbers and email addresses of individuals from whom you are requesting letters of recommendation. Two (2) are required, one of which must be from the person most familiar with your scholarly work. Please send the two letters of recommendation together with your application form. 1. Name __________________________ Email ___________________________________________ Phone/fax ____________________
Address ______________________________________________ 2. Name __________________________
Email ___________________________________________ Phone/fax ____________________
Address ______________________________________________
13. List any Harvard University Faculty member(s) with whom you wish to consult during the stay of the fellowship. Name ____________________ ____________________ Department ________________________ ________________________ Field ________________________ ________________________
List the above Harvard faculty members’ two publications (with detailed citation information) that are highly relevant to your research. 1._____________________________________________________________________________________ 2. _____________________________________________________________________________________ 14. Previous fellowships, scholarships, grants, and other honors (attach a list if the provided space is insufficient) ____________________________________________________________________________________________________ ____________________________________________________________________________________________________ ____________________________________________________________________________________________________ 15. What is the funding source for your research stay at Harvard? _______________________________________________ ____________________________________________________________________________________________________ 16. Are you a former fellow of the Institute? ________ If yes, specify which program (i.e., Visiting Scholars Program, Doctoral Scholars Program, or Visiting Fellows Program) and the dates: __________________________________________
17. Title of your proposed research: ______________________________________________________________________ _____________________________________________________________________________________________________
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18. List all positions, academic or other, in reverse chronological order, with dates, including the date from which you have held your present faculty position: ____________________________________________________________________________________________________ ____________________________________________________________________________________________________ ____________________________________________________________________________________________________ ___________________________________________________________________________________________________ 19. Publications where applicable. Please list titles in the original language as well as English. Attach a separate bibliography if space here is insufficient: _____________________________________________________________________________________________________ _____________________________________________________________________________________________________ _____________________________________________________________________________________________________ _____________________________________________________________________________________________________ 20. Foreign travel: If you have visited or lived in any countries other than the one in which you are now employed, please give places, dates, and purpose for visit: ____________________________________________________________________________________________________ ____________________________________________________________________________________________________ ____________________________________________________________________________________________________ ____________________________________________________________________________________________________ 21. Indicate your knowledge of the languages listed below and any others. If one is your own language, write native. Otherwise write slightly, fairly well, or fluently. ENGLISH: CHINESE: JAPANESE: KOREAN: THAI: Speak _______________ Speak _______________ Speak _______________ Speak _______________ Speak _______________ Read _______________ Read _______________ Read _______________ Read _______________ Read _______________ Read _______________ Read _______________ Read _______________
VIETNAMESE: Speak _______________ OTHER (______________): OTHER (______________):
Speak _______________ Speak _______________
22. What is the subject of your research plan? Give a description in English in about 3-5 pages, explaining your research plans at the Harvard- Yenching Library. Please insert the extra page(s) in this application form if necessary.
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23. AGREEMENT: If I am awarded Harvard-Yenching Institute Coordinate Researcher Status at Harvard University, I will return to my duties at my employing university in Asia at the conclusion of my fellowship, OR at such earlier time as my home university and/or the Harvard-Yenching Institute may require. If I am awarded the status, I will apply for a J-1 (scholar) visa to enter the United States. Signed ___________________________________ Date ___________________________________
PART TWO: INSTITUTIONAL APPROVAL (to be signed by the President, Vice-Chancellor, Rector, Dean of Faculty, or other appropriate administrative officer of the applicant's sponsoring university in Asia.) Application is incomplete without approval. TO: Coordinate Research Program HARVARD-YENCHING INSTITUTE Vanserg Hall, Suite 20 25 Francis Avenue Cambridge, MA 02138 USA We approve and recommend the application of ___________________________________for a Fellowship. This university will grant the above-named faculty member a suitable leave of absence if he or she is awarded HarvardYenching Institute Coordinate Research Status at Harvard University, where s/he will do research in his/her designated field. At the conclusion of the Fellowship, or earlier if required under terms of the applicant's agreement (Part One, item 23) the said faculty member is expected and obligated to resume appropriate duties at this university/institution.
Signed ___________________________________ Title ___________________________________
Date
___________________________________
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