NOMINATION SUMMER 2015 STUDY OF THE U.S. INSTITUTES FOR SCHOLARS

Title of Institute:

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The Institute on American Politics and Political Thought

The Institute on Contemporary American Literature

The Institute on Journalism and Media

The Institute on Religious Pluralism in the United States

The Institute on U.S. Culture and Society

The Institute on U.S. Foreign Policy

Nominees Full Name:

Gender:

Date of Birth: mm/dd/yyyy

Birth City:

Birth Country:

Address:

Country (ies) of Citizenship: El Salvador

Country of Residence: El Salvador

Medical, Physical, Dietary or other Personal Considerations:

Candidate Contact Information: office (503) home(503)

Cel phone (503) Current Position:

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Dean

Department chair

Senior professor

Associate professor

Consultant

Instructor

Title:

Institution name

Institution: El Salvador

Work Experience, including previous positions and titles:

From To Title / institution (please specify is the position is part-time mm/dd/yyyy mm/dd/yyyy

Education, Academic and Professional training, including degree earned and fields of specialization. Degrees listed should reflect the closest U.S. equivalent:

Degree earned Year earned institution mm/dd/yyyy

Additional professional training: NOMINATION SUMMER 2015 STUDY OF THE U.S. INSTITUTES FOR SCHOLARS

Active Professional Memberships:

Position Title Organization

Publications (up to ten):

Publication Type Year Title Publisher

Previous Experience in the United States:

Purpose From to Description mm/dd/yyyy mm/dd/yyyy

Family Residing in the United States:

Evidence of English Fluency: Professional responsibilities: NOMINATION SUMMER 2015 STUDY OF THE U.S. INSTITUTES FOR SCHOLARS

Current course taught:

Curse title Level of Classroom #of US studies students hour per students content (%) semester mm/dd/yyyy

Other potential outcome

Create new course National Curriculum University curriculum redesign redesign Create new degree Ministry policy Raise institutional profile program

Update existing course New publication New professional

organization National curriculum Professional promotion New institutional linkag redesign

Personal Statement: limit 4,500 characters