1

street address / interior number / exterior apt number

city / town

indicate international dialing code

indicate international dialing code

state / province zip code

In case this form is altered the application will be canceled automatically

Current photo (no more than 30 days) with the following specifications: white background, frontal view, no glasses, head and face exposed, without smiling.

Upload on .pdf format

(if applicable)

dd/mm/yyyy

indicate international dialing code

LAST NAME(S):

NAME (S):

NATIONALITY:

CURRENT ADDRESS:

HOME PHONE NUMBER:

CELLPHONE NUMBER:

GENDER:

EMAIL ADDRESS:

PASSPORT NUMBER: BLOOD TYPE:

COUNTRY OF ORIGIN: CURRENT COUNTRY OF RESIDENCE:

CIVIL STATUS:

SPOUSE OR PARTNER’S NAME

DATE OF BIRTH:

OFFICE PHONE NUMBER:

INFORMATION ABOUT THE APPLICANT

A P P L I C A T I O N F O R M

MEXICAN GOVERNMENT SCHOLARSHIP PROGRAM FOR INTERNATIONAL STUDENTS 2020

F M

FILL OUT THIS FORM ON A COMPUTER. NO HANDWRITTEN TEXT WILL BE RECEIVED

Plaza Juárez Núm. 20, Piso 4, Col. Centro, Alc. Cuauhtémoc, C.P. 06010, Ciudad de México.t. (55) 3686 - 5100 | www.gob.mx/amexcid

2

Mexican Government Scholarships for International StudentsCall 2020

dd/mm/yyyy dd/mm/yyyy(of the academic program)

dd/mm/yyyy dd/mm/yyyy

(of the academic program)

dd/mm/yyyy dd/mm/yyyy

RECEIVING MEXICAN INSTITUTION:

START DATE:

ACADEMIC CYCLE YOU ARE CURRENTLY STUDYING:

GRADE POINT AVERAGE:

SPECIFIC PERIOD FOR THE SCHOLARSHIP APPLICATION (START AND END DATES):

HAVE YOU ALREADY STARTED THE STUDIES:

ARE THE STUDIES YOU INTEND TO CARRY OUT IN MEXICO TAUGHT IN YOUR COUNTRY OF ORIGIN?

END DATE:

ACTIVITIES CONDUCTED DURING THE SCHOLARSHIP:

START DATE: END DATE:

ACADEMIC MODALITY TO BE CONDUCTED:

HAVE YOU OBTAINED A SCHOLARSHIP FROM THE MEXICAN GOVERNMENT?

START DATE: END DATE:

ACADEMIC ACTIVITY TO BE CONDUCTED IN MEXICO

YES NO

YES NO

YES NO

IT IS REQUIRED TO ENCLOSE SUPPORTING DOCUMENTS FOR THE APPLICATION

Plaza Juárez Núm. 20, Piso 4, Col. Centro, Alc. Cuauhtémoc, C.P. 06010, Ciudad de México.t. (55) 3686 - 5100 | www.gob.mx/amexcid

3

Mexican Government Scholarships for International StudentsCall 2020

In case of being on a different scale, it is required to present its equivalence.

indicate start and end dates

dd/mm/yyyy dd/mm/yyyy

FULL NAME OF THE RESPONSIBLE:

RECEIVING INSTITUTION:

EMAIL ADDRESS:

FROM WHICH INSTITUTION?

PHONE NUMBER: POSITION:

DO YOU HAVE ANY SUPPORT TO CONDUCT THE ACTIVITY FOR WHICH YOU ARE APPLYING FOR THIS SCHOLARSHIP?

ACADEMIC PERIOD:

TYPE OF SUPPORT:

UNDERGRADUATE STUDIES

ACADEMIC PROGRAM:

CITY AND COUNTRY:

INSTITUTION:

GRADE POINT AVERAGE:

START DATE: END DATE:

ACADEMIC INFORMATION

RESPONSIBLE AUTHORITY WITH WHICH YOU HAVE CONTACT TO CONDUCT ACTIVITIES IN MEXICO

yes no

THE GRADE POINT AVERAGE MUST BE INPUTED IN THE MEXICAN SCALE: 0/100

Plaza Juárez Núm. 20, Piso 4, Col. Centro, Alc. Cuauhtémoc, C.P. 06010, Ciudad de México.t. (55) 3686 - 5100 | www.gob.mx/amexcid

4

Mexican Government Scholarships for International StudentsCall 2020

dd/mm/yyyy

dd/mm/yyyy

dd/mm/yyyy dd/mm/yyyy

dd/mm/yyyy dd/mm/yyyy

dd/mm/yyyy

INSTITUTION OR COMPANY:

CURRENT WORK ACTIVITY:

JOB POSITION:

INSTITUTION OR COMPANY:

PREVIOUS EMPLOYMENT:

MASTER’S DEGREE STUDIES:

ACADEMIC PROGRAM:

CITY AND COUNTRY:

INSTITUTION:

DOCTORAL STUDIES:

END DATE

GRADE POINT AVERAGE:

START DATE: END DATE:

ACADEMIC PROGRAM:

CITY AND COUNTRY:

INSTITUTION:

GRADE POINT AVERAGE:

START DATE: END DATE:

ENTRY DATE:

JOB POSITION:

EMPLOYMENT INFORMATION

ENTRY DATE:

Plaza Juárez Núm. 20, Piso 4, Col. Centro, Alc. Cuauhtémoc, C.P. 06010, Ciudad de México.t. (55) 3686 - 5100 | www.gob.mx/amexcid

5

Mexican Government Scholarships for International StudentsCall 2020

(a maximum of 5)

(if applicable)

dd/mm/yyyy dd/mm/yyyy

INSTITUTION:

TEACHING AND RESEARCH ACTIVITIES CONDUCTED:

STARTING DATE: TERMINATION DATE:

NAME YOUR MOST RECENT PUBLICATIONS REGARDING THE ACADEMIC STUDIES TO BE CONDUCTED:

NAME THE DISTINCTIONS, AWARDS AND SCHOLARSHIPS OBTAINED INDICATING DATES:

TEACHING AND RESEARCH ACTIVITIES

RECENT PUBLICATIONS

DISTINCTIONS, AWARDS AND SCHOLARSHIPS

Plaza Juárez Núm. 20, Piso 4, Col. Centro, Alc. Cuauhtémoc, C.P. 06010, Ciudad de México.t. (55) 3686 - 5100 | www.gob.mx/amexcid

Mexican Government Scholarships for International StudentsCall 2020

6

indicate international dialing code

dd/mm/yyyy dd/mm/yyyy

dd/mm/yyyy dd/mm/yyyy

indicate international dialing code

GRANTING INSTITUTION:

NAME OF THE PERSON TO NOTIFY:

RELATIONSHIP:

APPLICANT’S SIGNATURE DATE AND PLACE

COUNTRY:

CELLPHONE NUMBER:PHONE NUMBER:

ADDRESS:

GRANTING INSTITUTION:

IN CASE OF HAVING OBTAINED NATIONAL OR INTERNATIONAL SCHOLARSHIPS TO CONDUCT STUDIES OR RESEARCH, NAME THE MOST RECENT:

COUNTRY IN WHICH YOU CONDUCTED YOUR STUDIES/RESEARCH:

I HEREBY ACKNOWLEDGE THAT I HAVE READ, UNDERSTAND AND ACCEPT THE TERMS AND CONDITIONS OF THE 2020 CALL OF THE MEXICAN GOVERNMENT SCHOLARSHIPS FOR

INTERNATIONAL STUDENTS

START DATE: END DATE:

START DATE: END DATE:

COUNTRY IN WHICH YOU CONDUCTED YOUR STUDIES/RESEARCH:

IN CASE OF EMERGENCY

IMPORTANT NOTE: THE INFORMATION CONTAINED IN THIS APPLICATION WILL BE VERIFIED BY AMEXCID. IN CASE IT IS FOUND TO BE FALSE THE REQUEST SHALL BE CANCELLED

Plaza Juárez Núm. 20, Piso 4, Col. Centro, Alc. Cuauhtémoc, C.P. 06010, Ciudad de México.t. (55) 3686 - 5100 | www.gob.mx/amexcid