African Studies Center∙Internatonal Insttute 1080 S University, Suite 3603 University of Michigan Ann Arbor, MI 48109-1106 Tel +1 734 615 3027 Email: asc-contact@umich.edu University of Michigan African Presidential Scholars Program 2011 Application and General Information Form Surname (as it appears on your passport) (Last, First, Middle) Other Names (as they appear on your passport): (first, middle, etc.) University Name Number of years as faculty in an insttuton of higher educaton University Address (street or PO Box, City, Code) Permanent Mailing Address (if different from insttuton address) E-mail Address(s) Telephone number (work) Telephone number (mobile) Fax number (if applicable) Length of Proposed Residency (number of months, beginning September, 2011) Title of Proposed Research Project Names of Suggested University of Michigan Faculty Mentors (if any) _ Research Abstract (max 100 words) Research Statement: Please attach to this form a statement of proposed research that does not exceed five double-spaced pages in length If proposing to research, please include discussion of your methodology If proposing a research collaboraton, indicate your research partners If proposing a period of writng, indicate the scope of your writng project and goals Applicant signature Date Due date for application is December 1, 2010 ... your research partners If proposing a period of writng, indicate the scope of your writng project and goals Applicant signature Date Due date for application is December 1, 2010 ... Please attach to this form a statement of proposed research that does not exceed five double-spaced pages in length If proposing to research, please include discussion of your methodology If