ASA Presidential Fellows Program Nomination Form

Nominee Information

Nominee (First Name, Last Name)*

First Last

Is Nominee based at a higher education institution or organization on the African continent?

To be eligible, nominee must be based at a higher education institution or organization on the African continent.

Yes
No

Nominee Title*

Nominee Affiliation*

Nominee Email Address*

Nominee Level of Study (if applicable)*

Is Nominee in Humanities or Social Studies Fields?*

Yes, Nominee is in Humanities or Social Studies fields.
No, Nominee is not in Humanities or Social Studies fields.

Nominee Field/Area of Study*

Nominee Country of Travel Origin*

Does the Nominee have an updated Passport?*

Yes, the Nominee has an updated passport for immediate travel
Yes, the Nominee has a passport but it must be renewed before travel
No, the Nominee does not have a passport but will apply immediately

Does the Nominee have a current US visa?*

Yes, the Nominee has a current visa covering travel during the event periods
Yes, the Nominee has a visa but it must be renewed before travel
No, the Nominee does not have a visa but will apply immediately

Nominator Information

Nominated By (First Name, Last Name)*

First Last

Nominator Title and Affiliation*

Nominator Email Address*

Are you (Nominator) an ASA member? Only current ASA members are eligible to nominate a candidate for this program. Members may each nominate only one (1) candidate, per Fellowship cycle

Yes
No

Nominator’s Statement
Use the space below, to describe your reason(s) for nominating this candidate. Please focus your statement on the following specifics:
a) In what capacity you know this candidate, and for how long you have known them
b) Please provide information about the candidates itinerary while they are in the States, and how you plan to make this a worthwhile experience for the Fellow
c) Why you think they should be an ASA Presidential Fellow (please tell us about the candidates experience, scholarly/advocacy engagement, etc)
d) Please provide any details and/or arrangements you have already made with your institution(s) as host, including available financial support for the fellow and the visit
Please limit response to 500 words

Nominator Statement – please upload your statement as a pdf*

Max. file size: 128 MB.

Candidate CV – please attach the candidate's CV as a pdf*

Max. file size: 128 MB.

Candidate Letter of Affiliation – please attach a letter of affiliation from the candidate's institution*

Max. file size: 128 MB.

Candidate Statement of Intent – please attach a statement of intent from the candidate. Please limit statement to 500 words.*

Max. file size: 128 MB.

You are now ready to submit your nomination. Please ensure that all the information on this form is correct, before hitting the “submit” button. Revised submissions will be disqualified.

ASA Presidential Fellows Program Nomination Application

Nominee Information

Nominator Information