CKS Visiting Scholar Application
Basic Information
First Name *
Last Name *
Email Address *
Confirm Email Address.
Date of Birth (mm/dd/yyyy) *
City of Birth *
Gender *

Home Address *
Work Address *
Phone Number *
Married *

Passport Number *
Photocopy of Passport *
(NOTE: you must click "Upload" after you select a file)
Expiration Date (mm/dd/yyyy) *
Country of Citizenship *
Research Information
Title of Research Proposal *
Proposal *
(NOTE: you must click "Upload" after you select a file)
Proposed Visit
Beginning Date, starting at the beginning of the month (mm/dd/yyyy) *
Ending Date (mm/dd/yyyy) *
Have you previously been a UCLA Visiting Scholar? *

Education Information
Highest Degree Earned *
Date Awarded (mm/dd/yyyy) *
Curriculum Vitae/Resume *
(NOTE: you must click "Upload" after you select a file)
Occupation in Home Country *
Employer *
Letter of Recommendation (non-academics only)
(NOTE: you must click "Upload" after you select a file)
Letter of English Language Proficiency *
(NOTE: you must click "Upload" after you select a file)
Financial Support
Funding Options *

Funding Agency *
Funding Amount (USD $) *
Financial Support Letter *
(NOTE: you must click "Upload" after you select a file)
Dependents
Add Dep 1
Payment
A $500 non-refundable fee is required to complete this visa application. *