Dear American Fulbright Alumna,

Kindly complete this form and send it back to us (via email, fax or post), in order to register into our American Alumni mailing list or in case you wish to update your information with our database. This will help us to remain in touch with you and alert you to arising opportunities and events. Thank You.


Jordanian-American Commission for Educational Exchange (JACEE)

P.O.Box 850215 Amman 11185, Jordan. Tel: (962-6) 568-4760 Fax: (962-6) 568-4820


 
Please check all that applies to you:
CHOICE OF NEW REGISTRATION VERSUS CHANGE OF ADDRESS / INFORMATION
 
Personal Information
Family Name:
First Name:
Middle Name:
Date Of Birth (Month-Day-Year): Select date
City Of Birth:
Country Of Birth:
Gender:
Marital Status:
Personal Coordinates
Home Address (Street & Postal Address, City, Country):
Home Tel (with Area Code):
Mobile No (with Area Code):
E-mail(Personal) (1):
E-mail(Personal) (2):
Work / Professional Information
Current Profession:
Job Title:
Employer (Name of Institution):
Office Address (Street & Postal Address, City, Country):
Office Tel (with Area Code):
Office Fax (with Area Code):
E-mail (Office):  
Grant Information
Grant Program or Category:   
  Other (1) Specify: Other (2) Specify:
Grant Type:
Grant Year(s):
Field Of Study or Research:
Name of Jordanian Host Institution:
Name of Home U.S. University:
Comments
Comments: