Permission to Record Oral Proficiency Interview 1828 L Street NW, Suite 1200, Washington, DC 20036, USA
Delivery Deadline: January 15. 20132 DATE:
TO:
INSTRUCTIONS TO STUDENT (This is a "fill-in" form): 1. Type your information onto the lines in this section. 2. Print the form (You may also Save your filled-in form.) 3. Sign the form. 4. Upload a scanned copy of your signed form to your online application. American Councils for International Education: ACTR/ACCELS (“American Councils”) 5. Mail your original signed form to Russian Flagship at the address below.
FROM:
[Applicant complete this section]
[Applicant enter current date]
Applicant’s Name:
,
Applicant’s Address:
,
(the “Applicant”)
I, the Applicant, hereby grant permission to American Councils to record the Oral Proficiency Interview (“OPI”) that may be required as part of my application to the Russian Flagship Program. I understand that the OPI may be conducted over the telephone or in person, at the discretion of American Councils. By: Applicant X
[Applicant sign here]
INSTRUCTIONS TO APPLICANT: 1. 2.
Complete and sign this form, then upload a legible scanned copy with your application to American Councils. Mail the original signed form for delivery no later than January 15. 2013 to: Russian Overseas Flagship Program American Councils for International Education 1828 L St NW Ste 1200 Washington DC 20036-5136
1828 L Street NW, Suite 1200, Washington, DC 20036, USA Afghanistan Albania Armenia Azerbaijan Belarus Bosnia and Herzegovina Bulgaria China Croatia Egypt Georgia Jordan Kazakhstan Kosovo Kyrgyzstan Macedonia Moldova Montenegro Nigeria Russia Serbia Syria Tajikistan Tanzania Turkmenistan Ukraine phone[202]833-7522
f a x [ 2 0 2 ] 8 3 3 - 7 5 2 3
w w w. a m e r i c a n c o u n c i l s . o r g
[email protected]