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RM_StatsPersonal InformationEducationEmergency Contact InformationProfessional Experience and InterestsPersonal StatementsLetter of RecommendationTerms and ConditionsPage 8First Name *Last Name *Email *Mobile Phone Number *Please include country code (+387)Gender * Female Male Other Date of Birth *Country of Birth *Skype ID (Leave blank if you do not have a Skype account)City of Birth *Citizenship *Current place of residence Address * City * Afghanistan Aland Islands Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas, The Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory Brunei Darussalam Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Congo, The Democratic Republic Of The Cook Islands Costa Rica Cote D'ivoire Croatia Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands (Malvinas) Faroe Islands Fiji Finland France French Guiana French Polynesia French Southern Territories Gabon Gambia, The Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Heard Island and the McDonald Islands Holy See Honduras Hong Kong Hungary Iceland India Indonesia Iraq Iran Ireland Isle Of Man Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati Korea, Republic Of Kosovo Kuwait Kyrgyzstan Lao People's Democratic Republic Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macao Macedonia, The Former Yugoslav Republic Of Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia, Federated States Of Moldova, Republic Of Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Northern Mariana Islands Norway Oman Pakistan Palau Palestinian Territories Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Reunion Romania Russian Federation Rwanda Saint Barthelemy Saint Helena Saint Kitts and Nevis Saint Lucia Saint Martin Saint Pierre and Miquelon Saint Vincent and The Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia and the South Sandwich Islands Spain Sri Lanka Sudan Suriname Svalbard and Jan Mayen Swaziland Sweden Switzerland Taiwan Tajikistan Tanzania, United Republic Of Thailand Timor-leste Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States United States Minor Outlying Islands Uruguay Uzbekistan Vanuatu Venezuela Vietnam Virgin Islands, British Virgin Islands, U.S. Wallis and Futuna Western Sahara Yemen Zambia Zimbabwe Country * Postal Code * Medical, Dietary, Disability or other Personal Considerations:Please describe any pre-existing medical conditions, including any prescription medication the candidate may be taking, or any other dietary or personal consideration. This will not affect candidate selection, but will enable the host institution to make any necessary accommodations. If none, leave blank.How did you hear about the BOLD Program? * Website of the U.S. Embassy in BiH Incubator or Startup Hub Network 20/20's website LinkedIn Recommended by a colleague/friend Academic Instution Browsing the internet Other Please select one optionFamily Residing in the U.S. * Yes, I have close family members residing in the U.S. No, I do not have close family members residing in the U.S. OtherIf yes, please also check the "other" checkbox and include the name of your family member and city/state (Example: John Doe – Chicago, IL)Have you traveled to the U.S. before? * Yes, I have traveled to the U.S. before. No, I have not traveled to the U.S. before. OtherIf yes, please also check the "other" section and indicate the duration; when did visit take place month/year; purpose of the visitName of University, City *Major/Field of Study, Department *example, IT Management, Management DepartmentGrade Point Average *Current Year of Study *Press ctrl or ⌘ (in Mac) while clicking to select multiple options.Select optionsFirstSecondThirdFourthFifthIf graduated, see below questionWhen did you graduate?Please indicate month/yearAwards and HonorsList any awards, formal academic recognition, or other certificate of achievement. (Please add multiple lines if needed)Emergency Contact Name and Relationship *Example: John Doe, FatherEmergency Contact Phone Number *Please include country codeInternship or volunteer experiencePlease add additional experiences belowMemberships in Associations, Clubs, etc., if not included in internship and volunteer experiencePlease add additional experiences belowLinkedIn ProfileSelect of areas of greatest interest (Up to three sectors should be selected) * Agriculture Artificial Intelligence Augmented Reality Consumer Products and Services Cryptocurrency Education Energy Entertainment Environment Financial Services Fintech Healthcare Human Resources Lifestyle and Wellness Logistics and Transportation Manufacturing Marketing and Advertising Retail and E-commerce SasS Software Security Other Up to three sectors should be selectedEvidence of English Fluency - Please note if you have taken a language proficiency test, lived abroad, or taken English language courses. If you have taken any language proficiency test please provide the date it was taken and your test score if you have taken English language courses please indicate your level of English in the course OR indicate your English proficiency using the Common European Framework for Languages (CEFR) *Link to the Common European Framework of Reference for Languages is belowTell us about yourself and how your personal experiences have influenced your educational and personal ambitions *Do you have an idea for a business model or project (profit or non-profit) that you want to implement in your community to improve the economy. How do you expect this experience will affect your community? How will it affect you personally and benefit your career goals? If you do not have a specific idea, please think of a challenge in your community that you feel passionate about. What skills would you need to develop in order to address and potentially resolve this challenge? *Common European Framework of the Reference for Languages (CEFR)Please submit along this completed application one letter of recommendation from someone who knows you well and can attest to your personal, academic, or professional experience and ambitions *Please send as .doc or .pdf fileThe BOLD Program includes in-person and online meetings that will take place in the Spring/early Summer prior to the trip to the United States. If you are selected for the fellowship, will you be able to commit and attend the mentioned segments of the program prior to the visit to the United States? * Yes No The BOLD Program includes a visit to the United States towards the end of the summer of 2020. If you are selected for the fellowship, will you be able to commit to a five week program in the United States? * Yes No If selected to the BOLD Program, I understand that I will be part of a diverse cohort with a multi-ethnic and multi-religious background * Yes No