BIFP Candidate Application Question Title * 1. Please complete the following contact information. Name: * College: * Address: * Address 2: City/Town: * State: * -- select state -- AL AlabamaAK AlaskaAS American SamoaAZ ArizonaAR ArkansasCA CaliforniaCO ColoradoCT ConnecticutDE DelawareDC District of ColumbiaFM Federated States of MicronesiaFL FloridaGA GeorgiaGU GuamHI HawaiiID IdahoIL IllinoisIN IndianaIA IowaKS KansasKY KentuckyLA LouisianaME MaineMH Marshall IslandsMD MarylandMA MassachusettsMI MichiganMN MinnesotaMS MississippiMO MissouriMT MontanaNE NebraskaNV NevadaNH New HampshireNJ New JerseyNM New MexicoNY New YorkNC North CarolinaND North DakotaMP Northern Mariana IslandsOH OhioOK OklahomaOR OregonPW PalauPA PennsylvaniaPR Puerto RicoRI Rhode IslandSC South CarolinaSD South DakotaTN TennesseeTX TexasUT UtahVT VermontVI Virgin IslandsVA VirginiaWA WashingtonWV West VirginiaWI WisconsinWY Wyoming ZIP: * Email Address: * Phone Number: * Question Title * 2. Subject(s) taught: Question Title * 3. How long have you been teaching? Years Months Please choose one. 1 2 3 4 5 6 7 8 9 9+ Please choose one. Years menu 1 2 3 4 5 6 7 8 9 10 11 12 Please choose one. Months menu Question Title * 4. What level of education are you teaching High School Community College University Question Title * 5. I am a (choose one) Full-time/Part-time instructor. NA Full-time Part-time Question Title * 6. Name and title of the person who nominated you. Question Title * 7. Tell us why you are interested in this Fellowship and how you plan to apply the experience when you return home. (In 500 words or less) Question Title * 8. Describe your impact as an instructor and your leadership potential. (In 500 words or less) Done