app form 2013 south africa

7/28/2019 App Form 2013 South Africa

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PLEASE ATTACH

RECENT PHOTO

Commonwealth Scholarship andFellowship Plan

APPLICATION FOR A COMMONWEALTH SCHOLARSHIP IN SOUTH AFRICA

1.a) TITLE (delete asapplicable)

Mr / Mrs / Miss / Ms / Other

1.b) NAME (underlinesurname)

2.a) PERMANENT ADDRESS

2.b) EMAIL ADDRESS

3. ADDRESS FOR CORRESPONDENCE (if different from above)

4. TELEPHONENUMBER

5. DATE OF BIRTH

6. NATIONALITY 7. MARITAL STATUS

8. NAME, ADDRESS AND RELATIONSHIP TO YOU OF PERSON TO BE INFORMEDIN CASE OF EMERGENCY

9. PREFERRED INSTITUTION OF STUDY (please list at least twoinstitutions) :

10. PROSED COURSE OF STUDY :

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11.a) EDUCATIONAL RECORD (in chronological order)

From To School/college/universityQualifications (includingcourse title and subjectsstudied)

ATTACH A CERTIFIED COPY OF YOUR UNIVERSITY OR COLLEGE TRANSCRIPT

11.b) If you intend to sit for an examination or complete a qualificationbefore taking up this scholarship, provide details and expected result date

11.c) Academic distinctions or prizes received. List any publications or titlesof theses submitted for any degree (state degree, date, and whethersuccessful)

11.d) Other distinctions gained or offices held during your educationalcareer

12. PRESENT OCCUPATION OR EMPLOYMENT

13. KNOWLEDGE OF FOREIGN LANGUAGES (indicate as good/fair/poor)

Language Reading Writing Speaking

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14. PERSONAL ACHIEVEMENTSa) List achievements which you consider are indicative of personal qualities,capabilities, initiative, and potential

b) Extracurricular activities, interests

15. WHAT COURSE DO YOU PROPOSE TO STUDY?

a) Qualification

b) Subjectc) Length of proposedcourse16. PLAN OF STUDYDescribe (in no more than 200 words) why you have chosen this particularcourse of study and university, any particular aspects of the course that youfind particularly attractive, and how the course would fit with your futurecareer plans

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17. HAVE YOU ALREADY APPLIED TO THE UNIVERSITY OR HAD ANY CONTACTWITH STAFF THERE REGARDING THIS COURSE OF STUDY? If yes, pleaseprovide details.

18. HAVE YOU APPLIED FOR ANY OTHER SCHOLARSHIPS OR AWARDS? Pleasegive brief details

19. REFEREESName three people whom you are asking to supply a confidential referenceabout you. Two of them should be people who have taught you in an area ofstudy relevant to the proposed course. The referees should send theirreports direct to your national agency (as below) for enclosure with theapplication form.

Name Address

Position

Name Address

Position

Name Address

Position

20. ANY OTHER INFORMATION WHICH YOU CONSIDER RELEVANT TO THISAPPLICATION

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21. DECLARATION BY APPLICANT

I declare that I am normally resident in my home country and that thestatements made in this application are, to the best of my belief, true,complete and correct. If awarded the scholarship, I undertake to return tomy home country at the end of the scholarship.

SIGNATUREDATE

Please return 3 copies of this form to your national nominating agency.Names and address of the agencies can be found on the CSFP website:http://www.csfp-online.org/agencies.html

Closing date: 30 June 2013

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app form 2013 south africa

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