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Application form for CICP Research Fellow/Intern

Scholars wishing to affiliate with CICP as a Senior Research Fellow, Research Fellow, or Intern are invited to submit a current curriculum vitae, as well as this completed application form. Applications to join the Fellow/Intern Program are accepted on a rolling basis, but should be submitted well in advance of the proposed start of residency. The following restrictions apply:

1. Applicants must be able to provide their own financial support during residency
2. Applicants for Research Fellow positions must conduct research on Southeast Asia in any discipline, or on broader topics after consultation with CICP, during the term of residency.

Name *

First

Last

Gender *

• Female
• Male

Title at home institution *

Home institution *

Home street address *

City *

State *

Post code *

Country *

Telephone *

Include country code

Cell *

Email *

Address in Cambodia (if different)

Street address

City

Telephone

I am applying for *

• Senior Research Fellow
• Research Fellow
• Internship

Proposed dates in Residence at CICP: *

Include day, month and year of your arrival and departure

Area(s) of Specialization *

Research Topic while at CICP *

Funding source while at CICP *

Highest Academic Degree *

Please indicate level of English competency in writing *

• Excellent
• Very Good
• Good
• Fair
• Poor

Please indicate level of Khmer competency (highlight): *

• Excellent
• Very Good
• Good
• Fair
• Poor

Personal essay *

In 2-3 paragraphs, please tell us about yourself and your goals, including the following: Why would you like to affiliate with CICP? How do you expect this experience will affect your future academic and professional career? What will you contribute to the institute? (250 words maximum)

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