Please complete the following to express your interest in applying to the FH DDRA. First Name: Last Name: Department: Preferred Email: Best phone number to reach you: Are you currently employed by the UA? (As a graduate assistant or otherwise) Yes No Other Are you eligible to apply for the grant? Information on eligibility can be found here: https://grad.arizona.edu/ofce/application-support/fulbright-hays-doctoral-dissertation-research-abroad Yes No Unsure Date you expect to or did pass to candidacy: Country(ies) where you plan to do research abroad: Date you would like to depart: Must be between October 1, 2023 - March 31, 2025, depending on how many months you plan to spend in country. How many months would you like to spend in country? Must be 6 -12 consecutive months If you have identified your affiliation(s) in the country of research, please list. In what language will you conduct the research? Advisor name: Advisor email: Advisor phone: Leave this field blank