Fulbright Affiliation

Personal Information

Accommodation & Transportation

Remarks & Signature

I. Category

How are you affiliated with Fulbright?

Please choose

II. Personal Information

Gender

Other gender

Academic Title

First Name

Last Name

Date of birth

Preferred Name

Note: This is how your name will be printed on your nametag. Please adjust if needed.

Fulbright Host Country

Current Mailing Address

Address c/o

(provide a c/o contact if needed for your address)

Phone

Note: This email address will identify you within our registration system. Please always use this email address for additional registration processes and communication with us.

Dietary restrictions

Access requirements/special accommodations

Field of Study/Research

Note: Please complete the following fields as best as you can!

For US Grantees: provide host institution (teaching assistant - school name) and last degree-receiving US institution.

For German candidates: if US institution has not been confirmed please indicate preferred institution. Please inform us of any changes.

Institution Name (Germany/EU)

Institution City (Germany/EU)

Institution State (Germany/EU)

Institution Name (US)

Institution City (US)

Institution State (US)

IV. Accomodation

Standard registration and accommodation period is April 21 (arrival) to April 24 (departure).

Standard arrangement: students and teaching assistants will routinely be accommodated in double rooms, which may not necessarily have twin beds. Grantees in Berlin will not be offered hotel accommodation for vicinity reasons. Please note: If you do not indicate a specific roommate below, we will automatically match you with a grantee of the same gender.

I do need accommodation

I'd like to share a room with:

First Name

Last Name

Otherwise I would like to share a room with:

Fulbright Affiliation

Please note: If you do not indicate a specific roommate,
we will automatically match you with a grantee of the same gender.

Transportation

Only for German Grantees / Alumni and US Grantees / Alumni in Germany who are not based in Berlin.

I request reimbursement

(I request standard reimbursement of EUR 100)

Signature

I hereby confirm that the stated information is correct.

Do you agree with your name being published on the attendee list?

I agree to be listed

Declaration of data protection consent

By submitting my registration for the Fulbright Seminar April 21 - 24, 2023, I agree that my personal data may be stored and processed for the purpose of the seminar administration. This also applies to other individuals (spouse, children) included in my registration.

Fulbright Germany has informed me that they intend to use photos and videos from this seminar for the following purposes:

for our homepage (www.fulbright.de)
for our social media channels (e.g. Facebook, Instagram)
for one of our publications (e.g. annual report)

The publication will be available for an indefinite period of time.

It has been pointed out that photos / videos from the Internet can be retrieved by any person. It cannot be ruled out that such individuals may further use the photos or pass them on to other people.

I am aware that I can revoke this consent at any time in writing: German-American Fulbright Commission, Lützowufer 26, 10787 Berlin or via email to: data-protection[at]fulbright.de.

Please also note our general data protection regulations at: https://www.fulbright.de/datenschutz

I hereby confirm that I have read and agree with the above-stated privacy policy.