2012 MEXICAN GOVERNMENT SCHOLARSHIP PROGRAM FOR FOREIGN CITIZENS
APPLICATION FORM B / SPECIAL PROGRAMS
FOTO
ACTIVITY TO BE CONDUCTED IN MEXICO
The scholarship is for the following type of academic activity:
( ) Speaker
( ) Visiting professor
( ) Journalist/Media
(
(
) Researcher
) Artist Residency
Title of the conference, course, seminar, research, artistic work or press article for which the scholarship is
sought: ___________________________________________________________________________________
___________________________________________________________________________________________
Receiving institution: __________________________________________________________________________
Start of activity: _______/_______/________
Day
Month
End date: ________/________/________
Year
Day
Month
Year
GENERAL INFORMATION
Name: ____________________________________________________________________________________
Paternal Last Name
Mother’s Maiden Name
First Name(s)
Nationality: ________________________________________________________________________________
Sex:
(F)
(M)
Date of Birth: ______ /_____/____
Year
Month
Day
Marital Status: Single ( ) Married ( ) Free union ( ) Divorced ( ) Other: (specify) _____________________
Address: ___________________________________________________________________________________
Street Address
____________________________________________________________________________________________
City
State/Province
Country
Zip Code
Telephone (with country code): _________________________ Office telephone: __________________________
Email: ____________________________________________________________________________
(*) The Foreign Ministry may contact you officially by email.
HANDWRITTEN APPLICATIONS WILL NOT BE ACCEPTED
ACADEMIC CONTACT FOR THE ACTIVITY TO BE CARRIED OUT IN MEXICO
Name: ____________________________________________________________________________________
Institution: _________________________________
Position:__________________________________
Telephone: __________________________________
Email: ___________________________________
Will you receive any other support for the activity for which you are requesting the Foreign Ministry scholarship?
Yes (
)
No (
)
From which institution:____________________________ Time period: __________________________________
ACADEMIC INFORMATION
Bachelor’s degree: _________________________________________
Institution: __________________________________________ Start and end dates: ____________
City and country: _______________________________________
Master’s degree: ____________________________________________
Institution: __________________________________________ Start and end dates: ____________
City and country: _______________________________________
Doctorate: ___________________________________________
Institution: __________________________________________ Start and end dates ____________
City and country: _______________________________________
List any other degrees, indicating institution, city, country and years:
____________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
Languages
Native language: ______________________________________________________________________________
Other languages:______________________________________________________________________________
If the native language is not Spanish, indicate proficiency in Spanish: ____________________________________
EMPLOYMENT BACKGROUND
Current Employment:
Institution or company: ____________________________ Position:_____________________________________
Start date: _____________________________________
Previous Employment:
Institution or company: _____________________________ Position:____________________________________
Number of years at company: ______________________________________
TEACHING OR RESEARCH ACTIVITIES
Indicate teaching or research activities, past and present, institution and dates:
___________________________________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
RECENT PUBLICATIONS
Titles of the three most recent publications related to the planned activity (include dates):
___________________________________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
HONORS, AWARDS AND SCHOLARSHIPS/GRANTS
Academic awards, honors, etc. received: ________________________________________
Scholarships for studies or research abroad. Indicate the granting institution, country where the activity was
conducted and the start and end dates: ___________________________________________________________
____________________________________________________________________________________________
ADDITIONAL INFORMATION
If applicant already resides in Mexico, give date of arrival: ______/______/_______
Day
Month
Year
Address: ___________________________________________________________________________________
Street Address
___________________________________________________________________________________________
City
State/Province
Country
Zip Code
Telephone (with country code): __________________________
Cellular:____________________________
Email: _______________________________
Specify what type of visa is held and expiration date: ________________________________
IN CASE OF EMERGENCY, NOTIFY:
Name: ___________________________________________________________________________________
Relationship: ______________________________________________ Country:_______________________
Telephone (include country and area codes):________________________________________________________
Fax: _________________________________
Email: __________________________________
Address: ___________________________________________________________________________________
ACCEPTANCE
I accept the terms and conditions of the 2012 Foreign Ministry Scholarship Program for Foreign Citizens,
which include the Terms and conditions for Recipients of the Foreign Ministry Scholarships.
______________________________________
Signature of the Applicant
_______________________________________
Place and Date
Important Note: The information contained in this application will be verified by the Foreign Ministry. The
inclusion of false information is grounds for cancellation of the application.
IMPORTANT NOTES

The completed, original application must be submitted well in advance. Applications sent by fax or email will
not be accepted.

The Directorate General for Educational and Cultural Cooperation is responsible for purchasing the
international airplane ticket. No reimbursements will be made if the applicant or receiving institution
purchases the tickets directly.

If the economy class airfare involves a stopover or connection in a United States city, the scholarship
recipient must have the corresponding valid and current visa.

If the scholarship recipient cancels his/her trip once the airplane ticket has been issued by the travel agency
authorized by the Foreign Ministry, if the ticket is not refundable, the institution sponsoring the scholarship
recipient will be asked to pay for it.
2012 MEXICAN GOVERNMENT SCHOLARSHIP PROGRAM FOR FOREIGN CITIZENS
The following documents must be submitted with Application Form B.
1. Original application form (Application Form B for special programs), for the year in
which the activity will be carried out, completed in Spanish, signed by the applicant,
and with photo attached.
2. Letter from the receiving Mexican institution to the Foreign Ministry’s Director General of
Educational and Cultural Cooperation stating the special program for which the
scholarship is requested, with the title of the conference, research, lecture or artwork, as
appropriate, of the foreign citizen and the start and end dates.
3. If the nomination is submitted to the Mexican embassy or consulate in the candidate’s
country, attach the invitation of the receiving Mexican institution that specifies the dates
and place of the activity.
4. Curriculum vitae, in Spanish
5. For artist and media residencies and the Genaro Estrada scholarship for Mexican studies,
attach a letter stating why the candidate is interested in carrying out the project in Mexico.
6. For the Genaro Estrada program for Mexican specialists, visiting professors, and media
and artistic residencies, include 8 original photographs (not digital) if the residence is
longer than two months, or two photographs if it is shorter than two months.
7. Also include the specific requirements of the Special Program of interest.