CENTER FOR DEVELOPMENT ECONOMICS                                                         Academic Year 1998-99 
1065 Main Street                                                                                                                                        
Williamstown, MA 01267 U.S.A.
Internet: cde@williams.edu
Fax: (413) 597-4076

Form A: (To be filled out by the applicant and mailed directly to the Admissions Officer at the address above.)

 1. Name Ms., Mr., Mrs.______________________________________________________________

 2. Present position ____________________________________

   Organization ________________________________________

3. Office address _____________________________________________________________

Telephone _____________________       Fax ____________________    Email ________________________

 Home address __________________________________________________________________________

4. Date of birth (day/month/year) ____________________

Place of birth ________________________________________________________

5. Citizen of ____________________________________________________________

6. Dependents: Spouse____  Children____   Dependents accompanying you to Williams______________

7. Universities attended:
                                                                                                                                     Field of 
Name of Institution                              Location                  Degree                   Specialization             Dates (from-to)

____________________________________________________________________________________

 ____________________________________________________________________________________

 
8. Please give an indication of the quality of your academic performance.

Institution                                       Class of degree                                             Rank in class & class size
                                                         (honors, if any)                                                 (Example: 10 of 39)

____________________________________________________________________________________

______________________________________________________________________________________

9. List university courses or papers in economics, statistics, and econometrics: ___________________________

_______________________________________________________________________________________

_______________________________________________________________________________________

_______________________________________________________________________________________

 
10. List any post-B.A. courses of study (1 month or longer) which you have taken dealing with the application of economic analysis to development problems:

Institution                                       Location                       Degree (if any)               Subject matter                         Dates

_______________________________________________________________________________________

_______________________________________________________________________________________

11. Occupational experience since leaving university (list chronologically, present position first):

Employer                                    Positions Held                                               Dates (from-to)

_____________________________________________________________________________________

_____________________________________________________________________________________

_____________________________________________________________________________________

 
12. How do you use economics in your present position? (Be specific, and use examples):

_____________________________________________________________________________________

 _____________________________________________________________________________________

 _____________________________________________________________________________________

 
13. Indicate your proficiency in English: 
                                                                        Excellent                  Good                     Fair                         Poor
                                                                     (very fluent)         (adequate for       (needs review       (needs intensive
                                                                                                  graduate study)      and practice)                work)

Reading                                                           _____                   _____                    _____                      _____

Writing                                                            _____                   _____                    _____                      _____

Speaking                                                         _____                   _____                    _____                      _____

Understanding                                               _____                   _____                    _____                      _____

14. Was English the language of instruction at your university? Yes _____ no _____

If no: Date and score TOEFL __________________________________________________________

          OR Expected date of TOEFL ______________________________________________________

15. If you are admitted, will your agency or ministry provide funds to cover:

(a) your tuition and living expenses? yes_____ no_____ (b) international transportation? yes______ no_____

(c) summer program at Economics Institute, Boulder, Colorado? yes_____ no ______

16. From what other organizations are you or your employer requesting financial aid?

 ________________________________________________________________________________

 
17. List the name, position, and address of the supervisor who will complete your recommendation (Form B). How long has this official supervised your work?

________________________________________________________________________________

________________________________________________________________________________

 
18. Signature of applicant _____________________________________________________________

Please complete this form and mail it before the date of the interview. ATTACH A COPY OF YOUR UNIVERSITY TRANSCRIPT. Retain a copy of the application for the interviewer.