Enter the information below to submit the application.
Enter birth dates in US format (M/D/YYYY). Enter years as 4 digits (YYYY).

Part 1: Personal Information
First Name
Middle Name
Last Name
Address 1
Address 2
City
State/Providence
Postal Code
Country
Phone
Email Address
Date of Birth (M/D/YYYY)
City of Birth
Country of Birth
Country of Citizenship
Gender Male Female
Marital Status Single Married
Social Security Number
Type of Visa
International Address
(If the above address is in the United States.)

Part 2: Academic Interest
Application Type
Degree
Major
Special Interest
College/Dept.
Campus
Applying For Semester/Year

Part 3: Education Before College
Years in Primary School
Years in Middle School
Years in Secondary School
Secondary School
School Name
City
State
Country
Graduation Month/Year (YYYY)

Part 4: College Education

Institution Name
Location		 From:
Month / Year (YYYY)		 To:
Month /Year (YYYY)
Degree		 Received:
Month / Year (YYYY)
1.
2.
3.
4.
5.

Part 5: Finances
Financial Support
(Check all that apply)		 Private funds
NMSU graduate assistantship
USAID or FAO scholarship
Foreign government/university
Other agency sponsorship
Source of Support Sponsor Name Years of Support
USAID/FAO
Foreign Government
Other Agency Sponsor

Part 6: Dependents
First Name Middle Name Last Name Relationship Date of Birth
(M/D/YYYY)		 City of Birth Country of Birth
1.
2.
3.
4.
5.

(Click to submit the application)