Appendix D Annual Report--Exchange Visitor Program Services (GC/V), United States Information Agency, Washington, DC 20547,(202-401-9810)
Exchange Visitor Program No. ________ Reporting Period _______ Provide Range of Forms IAP-66 Documents Covered by this Report (_________-_________).
(a) STATISTICAL REPORT
(1) ACTIVITY BY CATEGORY Number
Research Scholars ______
Short-term Scholars ______
Students (College and University) ______
Students (Practical Trainee) ______
Students (Secondary) ______
International Visitors ______
Government Visitors ______
Camp Counselors ______
(2) Forms IAP-66 Reconciliation
(i) Number of Forms IAP-66 voided or otherwise not used by participant ___________ (ii) Number of Forms IAP-66 issued for dependents ________ (iii) Number of Forms IAP-66 currently on hand ____________
(b) PROGRAM EVALUATION
On a separate sheet, please provide a brief narrative report on program activity, difficulties encountered and their resolution, program transfers, anticipated growth and the proposed new activity, cross-cultural activities, as well as the reciprocal component of the program.
I, The Responsible Officer of the program indicated above, certify that we have complied with the insurance requirement (22 CFR 514.14). I also certify that the information contained in this report is complete and correct to the best of my knowledge and belief.
_________________________________________________________________ Responsible Officer (signed)
_________________________________________________________________ Name and address of sponsoring institution