German-American Science Slam 2020 1/3

German-American Science Slam 2020 Application Form

Please save this form as “ScienceSlam2020_LASTNAME_firstname_Part1.pdf” and fill it out electronically (using the late Adobe Reader), save it again and send as an email attachment to specialprograms@fulbright.de.

Please do not alter this application form (insert pages, change fields, etc.).

Personal information

academic title (if applicable) gender (male/female/diverse/NA) nationality (German and/or US)

first name middle name last name (as given in passport)

date of birth (DD/MM/YY) place of birth country of birth

Private contact information (current address)

care of/extra (if applicable) street and number postal code

city state country

email phone number cell phone number

Fulbright Affiliation (if applicable)

Please indicate your program name and grant year if you are a current Fulbright grantee or alumnus/a:

Travel information

If selected, I will be travelling to Cologne from: (German city)

German-American Science Slam 2020 2/3

Professional information (current position)

institution (complete name) department position

city state country

Educational background (beyond secondary school) in chronological order (beginning with most recent)

name and place of institution (complete name, city, country)

major field(s) of study degree received date of degree completion (month/year)

Please describe yourself, your personal interests - and state one fun fact about yourself (150-200 words).

German-American Science Slam 2020 3/3

In layman’s terms, please describe the topic of original research which you would present at the German-American Science Slam (150-200 words).

Please explain why you would like to participate in the German-American Science Slam. (150-200 words).

Video Introduction

As part of the application, we ask that you send us a short video (max. 1 minute long) in which you briefly - introduce yourself- introduce the topic of your research

This can be an informal video filmed with a mobile device. The video quality will not be judged – we hope to learn more about your “stage personality” and “delivery style.” You may think of it as the introduction of your eventual science slam presentation.

Upon receipt of your application, we will send instructions for electronically transferring your video to us.