MAASTRICHT UNIVERSITY

Application for the Holland Scholarship

Please submit this scholarship application form to the faculty no later than February 1st

2016. For more information, please check the website. To see where exactly you have tosend your application form, click here.

The Holland Scholarship is financed by the Dutch Ministry of Education, Culture and Science and Dutchresearch universities and universities of applied sciences. The scholarship is meant for internationalstudents from outside the European Economic Area (EEA) who want to study a full-degree programme inHolland. The EEA consists of the EU countries and Iceland, Liechtenstein and Norway.

Candidates must have met all the requirements of the application procedure.Please enclose the following documents:� Motivation letter regarding the application for the Holland Scholarship.� Photocopies of relevant grade lists.

1. Personal information

Surname: ........................................................................................................................

First name: ........................................................................................................................

Date of birth: ........................................................................................................................

Place of birth: ........................................................................................................................

Nationality: ........................................................ Gender: � Female � Male

Postal address: ..................................................................................................

Zip code & city: ........................................................................................................................

Country: ........................................................................................................................

Telephone: ................................................................................................................ ........

Fax: ........................................................................................................................

Email: ........................................................................................................................

Student ID number at Maastricht University: .......................................................................................

MAASTRICHT UNIVERSITY2. Chosen master’s programme at Maastricht University:

Name of the programme: ………………………………………………………………………………..

� One-year master’s programme� Two-year master’s programme

3. Other scholarships

Have you applied for any other scholarships? � Yes � No

Have you received a decision concerning the scholarship application(s)? � Yes � No

If yes, have you been awarded any scholarship(s)? � Yes � No

If yes,Name of the scholarship(s): ..........................................................................................................Total amount of the scholarship(s): € ...........................

4. Signature

I herewith apply for the Holland Scholarship and declare that I have completed this form to the best of myknowledge.

Date ................................................ Place ................................................

Signature ...........................................................................................................