Application Instructions.
Summary Procedures on How to Apply for Foreign National Student Internship
What to know before you begin:
There will be no compensation.
This is NOT an offer of U.S. Government employment.
There will be NO benefits such as leave accrual, health insurance or allowances.
Steps to Complete
1. Complete the following forms:
Application/Resume
Statement of Interest
Letter of Permission
Legal residency documentation (non-Togolese only)
Gratuitous Service Agreement
2. Obtain written permission from school and letters of recommendation, as applicable.
3. Request that the school send an official transcript of academic standing to the Human
Resources Office.
4. Submit all documents in Step 1 above including any certifications, licenses and
proficiencies as required to the U.S. Embassy Human Resources Office prior to the closing
date. You may either scan and email your application or deliver it directly to:
Lo[email protected] OR
Foreign National Student Internship Program
Ambassade des Etats Unis
4332, Boulevard Gnassingbé Eyadema
Cité OUA, Lomé, Togo.
B.P. 852
5. Be available for interview when/if called. English skills will be tested as part of the
interview process. If selected, be available for medical and security certifications
U.S. Embassy, Lomé
FOREIGN NATIONAL STUDENT INTERN PROGRAM (FNSIP)
APPLICATION FORM
1. Full Name:
Last (Surname) First (Given Name) Middle
ID card #:
2. Present address and telephone number:
**ADDRESS:
** Phone Number:
** Email Address:
3. How did you learn about this program?
Employee
Relative
School
Embassy website
Other (Please Specify):
4. University/School/Educational Institution:
For each institution you have attended, provide the following information in the space below.
Begin with your present school and work backwards. Use continuation sheets as necessary
Name of Educational Institution:
Major:
Year:
**When are you expecting to graduate?
Year: Month:
5. Current Citizenship: Other Citizenship (Please Specify):
7. U.S. Citizenship: Do you have any claim to U.S. citizenship? YES: NO:
8. Do you have any relatives that work for the Embassy?
YES (If yes, please list name, section where they work and how long they have
been employed.)
NO
Name (Last, First, Middle):
Section:
Years worked at the Embassy:
9. Languages: Identify the language and indicate extent of your competence for each:
(5 = Native; 4 = Fluent; 3 = Good; 2 = Fair; 1 = Poor; 0 = None)
Language Speak Read Write Understand
English - - - -
French - - - -
10. Computer Skills:
How do you rate your computer skills? Check one block:
5 = excellent;
3 = good;
1 = fair;
0 = none
List computer programs in which you have experience:
1.
2.
3.
List any training or Certificates:
1.
2.
3.
____ ____________________________________
Signature
___ _ ______________________________
Date (Month/Day/Year)
U.S. Embassy, Lomé
FOREIGN NATIONAL STUDENT INTERN PROGRAM (FNSIP)
STUDENT STATEMENT OF INTEREST
Print Name (Last, First, MI):
ID card #:
11. What are your objectives and motivations in seeking this internship?
12. Explain how the academic courses you have taken and other personal experiences, will make
you a good intern?
13. Describe your non-academic experiences:
(Add continuing pages if needed)
14. References
List at least one person not related to you by blood or marriage that is qualify to supply definite
information regarding your character and suitability as an intern under the program.
Name: Title:
ADDRESS:
PHONE:
15. YOU MUST SIGN THIS APPLICATION. Read the following carefully before you sign.
I understand that any information I give may be investigated and that a false statement may be
grounds for non-consideration or dismissal of my participation in the Intern Program, if I am
selected.
I understand that, if I am provisionally selected, an Embassy-required security certification is a
prerequisite.
I understand that, if I am provisionally selected, an Embassy-required medical examination and
medical certification is a prerequisite. I consent to the release of information about my ability
and fitness for the Intern Program by employers, schools, and law enforcement agencies and
other individuals and organizations to Embassy-authorized investigators and personnel.
I certify that, to the best of my knowledge, all of my statements are true, complete, and made in
good faith.
____________________________________
Signature
______________________________
Date (Month/Day/Year
U.S. Embassy, Lomé
FOREIGN NATIONAL STUDENT INTERN PROGRAM (FNSIP)
LETTER OF PERMISSON
The student above is granted permission to participate in the Foreign National Student Intern
Program (FNSIP) at the U.S. Embassy, Lomé, and will continue his/her
University studies immediately upon completion of the internship.
Date:
Authorized by:
Name/Title
Signature
Student’s Name:
ID No:
University:
Major:
Year:
GPA:
UNITED STATES DEPARTMENT OF STATE
GRATUITOUS SERVICE AGREEMENT
Title 5 Section 3111 of the United States Code authorizes federal agencies to establish programs
designed to provide educationally related work assignments for students on a nonpayment basis.
You will be hired under such a program.
According to the law, we may only accept your gratuitous service if the service:
(1) is performed by a student, with permission of the institution at which the student is enrolled;
(2) is uncompensated; and
(3) will not displace any employee.
As a student participating under this program you will not be considered to be a U.S. federal
employee for any purposes other than injury compensation or laws related to the Tort Claims
Act. Your service is not creditable for leave accrual or any other employee benefits.
This arrangement is subject to termination at any time at the discretion of the Mission. Please
sign below acknowledging that you understand the terms under which you will be hired.
I understand the terms under which I am being hired, including, without limitation,
that I will not be compensated for the services that I provide.
Type or Print Name
(Last,First,Middle)
DATE (month/day/year)