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www.americancouncils.org
FLEX Alumni Update Form
Please answer the questions below so that we may keep in touch
and inform you about upcoming alumni events.
The form should be completed in English.
Russia 119049 Moscow Leninsky pr. 2, room 503
(495) 638-4544, 638-4582, 956-7805
(495) 956 7806 (fax)
Please send the completed form toflexalumni@americancouncils.ru
www.americancouncils.org
| 1. Today’s Date | |
| Month Day Year | |
| 2. Personal Information: | |
| Last Name: | |
| First Name: | Middle Name: |
| Name at Time of Application to FLEX: | |
| Date of Birth: Month Day Year | Year of Return from FLEX: |
| Programs in which you have participated in addition to FLEX (circle all that apply): LEAP UGRAD TEA PIE MUSKIE MUSKIE PhD Fulbright RSEP JFDP Other | |
| Program Start Year and End Year: | |
| 3. Contact information where we can best reach you: | |
| Country: | Postal Code: |
| Region: | City: |
| Street Address: | This address is your (circle one): Home Work Other: ____________ |
| Preferred Phone (Country & city code & Number): | This phone is (circle one): Home Cell Work Other: ____________ |
| Mobile Phone (Code & Number): | Home phone (Code & Number): |
| Other Phone (Code & Number): | Fax (Code & Number): |
| Preferred Email Address: | Other Email Address: |
| 4. Alternate Contact (person who will know how to reach you): | |
| Last Name: | Relationship to You: |
| First Name: | Middle Name: |
| Country: | Postal Code: |
| Region: | City: |
| Street Address: | Email Address: |
| Preferred Phone (Code & Number): | Other Phone (Code & Number): |
| 5. Education after completing the program: | ||||
| Name of Institution: | Country/ City: | |||
| Department: | Year of: Entry: Graduation: | |||
| Field of Study (please, select one): 1. Accounting and Audit 2. Advertising 3. Agriculture and Forestry 4. Anthropology 5. Archaeology 6. Architecture 7. Area/ Regional Studies: (select one) - African Studies - American Studies - Asian Studies - European Studies - Middle Eastern Studies 8. Art History 9. Automobile Industry 10. Aviation 11. Banking and Finance 12. Biochemistry 13. Biology 14. Building and Construction 15. Business Administration 16. Chemistry 17. Computer Science and Programming 18. Conflict Resolution 19. Cross-cultural Communications 20. Design | 21. Diplomacy 22. Economics 23. Education: Curriculum/ Policy/ Special Needs 24. Engineering and Electronics 25. Entrepreneurship and Commerce 26. Environmental Studies 27. Ethnic studies 28. Finance and Credit 29. Foreign Languages Specify - _____________________________ 30. Gender Studies 31. Geography 32. History 33. HR Management 34. Human Rights 35. Insurance 36. International Relations 37. Investment and Credit Analysis 38. IT 39. Journalism, Media and Communication 40. Law 41. Library and Museum Studies 42. Linguistics and Intercultural Communication 43. Literary Studies and Creative Writing 44. Management | 45. Marketing 46. Mathematics 47. Medicine/ Surgery/ Pharmacy/ Veterinary 48. Military Sciences 49. Oil and Gas Technologies 50. Performing Arts: Music, Dance, Theatre 51. Philology 52. Philosophy 53. Physics and Astronomy 54. Political Science 55. PR 56. Psychology 57. Public Administration 58. Religious Studies 59. Social Work 60. Sociology 61. Statistics 62. Taxation 63. Teaching Specify: ______________________________ 64. Television, Film and Animation 65. Tourism and Hotel Business 66. Translation and Interpretation 67. Visual Arts: Painting, Photography, Sculpture 68. World Economics 69. World Politics 70. Other: _______________________________ | ||
| Specify your subject of studies: | ||||
| Degree: Bachelor’s Master’s PhD Other | Honors or Awards: | |||
| 6. Primary Employment: | ||||
| Company Name: | Title: | |||
| Professional Field/ Industry (please, select one): 1. Accounting 2. Agriculture/ Mining 3. Architecture/ Design 4. Arts/ Entertainment 5. Automotive 6. Computers/ Software/ Technology 7. Construction/ Engineering 8. Consulting 9. Education/ Teaching 10. Energy/ Utilities/ Fuel/ Chemicals 11. Finance/ Banking | 12. Government/ Social Services 13. Health Care/ Hospitals 14. Human Resources/ Recruiting 15. Import/ Export/ Trade/ Wholesale 16. Information Management/ Library 17. Insurance 18. International Relations/ Diplomatic Services 19. Legal 20. Manufacturing 21. Marketing/ Advertising/ Communications/ PR 22. Media/ Publishing/ Broadcasting | 23. Military/ Defense 24. NGOs/ Non-profit Organizations 25. Pharmaceuticals/ Biotech 26. Political Science 27. Real estate/ Property Management 28. Research & Development 29. Retail 30. Telecommunications 31. Translation/ Interpreting 32. Transportation/ Logistics 33. Travel/ Tourism business 34. Other: _______________________________ | ||
| Country/ Postal Code: | Region/ City: | |||
| Street Address: | Email Address: | |||
| Work Phone (Code & Number): | Work Fax (Code & Number): | |||
| Web Site: | Start Date: Month Year | |||
| 7. Signature: | ||||
| Signature: | ||||
| For Office Use Only: Received: ________________ FAS Entered: _________________ | ||||
Date: 2015-12-18; view: 1530
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| PART 3. Answer the following questions shortly. | | |