Apply Online

Applicant Information
Name*
First Middle Last
Gender
- Female
- Male
Status
- Unmarried
- Married
Have you applied to the USTTI in the past?*
- Yes
- No
If yes, what year(s)?
- Previous USTTI Participant
Organization/Employer Information
Organization/Employer*
Job Title*
Organization Street Address
Address*
City State / Province / Region ZIP / Postal Code Country
Telephone and E-mail
Personal E-mail Address*
Business E-mail Address*
Business Phone (country code/city code/number)*
Home Phone (country code/city code/number)
Mobile Phone (country code/city code/number)
Home Address
*
Street Address City State / Province / Region ZIP / Postal Code Country
Date of Birth
Date of Birth*
Citizenship
Place of Birth (City, Country)
Citizenship*
Passport #
Do you have a current U.S. Entry Visa?*
- Yes
- No
Expiry
Course Selections
1. Course Number / Title*
2. Course Number / Title*
3. Course Number / Title*
4. Course Number / Title*
Applicant Training Goals
Applicant Training Goals*
Please explain in 100-125 words how training you would benefit your company/organisation and your country. What potential leadership role might you play upon your return home?
English Language Ability
Reading*
- Excellent
- Adequate
- Poor
Writing*
- Excellent
- Adequate
- Poor
Speaking*
- Excellent
- Adequate
- Poor
Comprehension*
- Excellent
- Adequate
- Poor
Formal Education
Secondary
Institution
Location
Subject
Degree
Year Earned
University
Institution
Location
Subject
Degree
Year Earned
Other
Other
Institution
Location
Subject
Degree
Year Earned
Current Position and Professional Experience
Mention the details*
Describe your current and previous communications/IT responsibilities; where applicable please highlight managerial experience. Include types of systems/equipment with which you have worked, attendance at major conferences, awards, and any other accolades you have received.
Emergency Contact Information
Name*
First Middle Last
Address
City State / Province / Region ZIP / Postal Code Country
Phone (country code/city code/number)*
E-mail Address*
Please provide contact information for two relatives or friends in your home country. Please also provide the contact information of two relatives or friends in the United States. If do not have any contacts in the United States, please leave that section blank.
In-country:
Primary Contact Name
Relationship with Primary Contact
Primary Contact Phone
Primary Contact Email
Second Contact Name
Relationship with Second Contact
Second Contact Phone
Second Contact Email
In the U.S.:
Primary Contact Name
Relationship with Primary Contact
Primary Contact Phone
Primary Contact Email
Second Contact Name
Relationship with Second Contact
Second Contact Phone
Second Contact Email
Funding
My organization will pay for my travel and/or subsistence (check all that apply):*
- Travel
- Subsistence
- Neither
I am applying for USTTI support for (check all that apply):
- Travel
- Subsistence
Supervisor Information
Supervisor contact information, where appropriate, is required by the USTTI.
Supervisor Name*
Organization/Title*
Supervisor Telephone*
Supervisor E-mail*

Apply Online

Applicant Information

Organization/Employer Information

Telephone and E-mail

Home Address

Date of Birth

Citizenship

Course Selections

Applicant Training Goals

English Language Ability

Formal Education

Other

Current Position and Professional Experience

Emergency Contact Information

In-country:

In the U.S.:

Funding

Supervisor Information