NUMERUS GROUP SCHOLARSHIP 2018 – 2019

APPLICATION FORM

Introduction:

The Numerus Group Scholarship will provide financial support to one new and several

existing students at American University of Iraq, Sulaimani (AUIS) for the 2018-2019

academic year. Scholarships will be awarded based on need and merit, and will cover

tuition, fees, housing, and books. Please note that the scholarship is highly competitive and

will only be awarded to one new student, and two to three current students.

Eligibility: In order to be apply, new and current students must satisfy the following

conditions:

New students should have a minimum baccalaureate score of 80.

Current students must have a minimum GPA of 2.7.

Current students must be entering at minimum their second year (third semester)

of undergraduate study in Spring 2019.

Current students must reapply each year to renew their scholarship.

Students should be engaged in activities inside and outside the University.

Students must be able to demonstrate financial need as determined by the

University.

Instructions:

Please fill out the application below. Only completed applications will be considered. When

you have completed the application please send it and accompanying documents to

admissions@auis.edu.krd with “Numerus Group Scholarship” in the subject line.

Please make sure to name each required document properly using the following naming

system: FirstName_LastName_DocumentName

If you applied for the Numerus Group Scholarship last semester (Fall 2018) and were not

accepted, please resubmit your application to admissions@auis.edu.krd noting in the email

that you applied last semester and that you would like to be considered for the scholarship

for Spring 2019. **Please update your GPA information to reflect your current grades

for Fall 2018.

Applications are due January 12, 2019.

Please contact admissions@auis.edu.krd if you have questions about the application. Please

write “Question, Numerus Group Scholarship” in the subject line.

Important note on the falsification of information on this application:

**For current students: Please note that any false statement made about you or your family on this application will result in a strike against you through the office of the Dean of Students; the equivalent to a plagiarism case. As you know, after three strikes you will be expelled from AUIS.

**For new students/ applicants: Please note that any false statement made about you or your family on this application will immediately disqualify you from attending AUIS this year and in the future.

I. STUDENT INFORMATION

PHOTO (Attach student photo here)

Numerus Group Scholarship 2018-19

Today’s date: _____________

First Name: ________________________________________________________________

Last Name: _________________________________________________________________

Date of birth:________________(month)__________(day)_____________ (year)

_________ New student _________ Current student

AUIS Admissions Number:

(**New students must also apply to AUIS)

Home Country: ________________________

City/Town of birth: ________________________

High School City (if different): ________________________

Current City/Town (if different): ________________________

Are you displaced from your hometown? Yes_____ No_____

Are you going to stay in AUIS student housing? Yes____ No____

Telephone: _______________________________________________

Cell phone: ___________________________________________

E-mail (if available): ___________________________________________

For current students:

1. How many semesters have you completed at AUIS? ___________

2. How many semesters do you have until you graduate from AUIS? ___________

3. What is your overall GPA? ___________

4. What is your Fall 2018 GPA? ___________

5. What are your current grades for your Fall 2018 courses?

Course Grade

6. What is your Major? Minor? ______________________________

7. What was your baccalaureate score? ___________

8. What is your annual tuition fee? ___________

9. List AUIS activities you are involved in:

10. List internships, jobs, activities (name of company or organization, year you

worked/ participated/ volunteered) you are involved in outside of university?

11. Attach your CV/ resume to this application.

For new students:

1. Name of your high school? __________________________

2. Baccalaureate score? _______________

3. What do you plan on studying at AUIS?

_____International Studies _____Business Administration

______Information Technology ______Engineering

______English - Literature ______English - Journalism

_____Law _____Translation

______Medical Laboratory Science ______Software Engineering

______Not sure

4. List activities, internships, jobs (name of company or organization, year you

worked/ participated/ volunteered) you are involved in?

5. If available, attach your CV/ resume to this application.

For all applicants:

Why do you feel you have earned this Scholarship and how will it help you succeed at

AUIS and in your future professional life? Please tell us about your background, as

well as your plans for studying at AUIS, and how you will use your education in your

future career and life?

_________________________________________________________________________________________________________

_________________________________________________________________________________________________________

_________________________________________________________________________________________________________

_________________________________________________________________________________________________________

_________________________________________________________________________________________________________

_________________________________________________________________________________________________________

_________________________________________________________________________________________________________

_________________________________________________________________________________________________________

_________________________________________________________________________________________________________

_________________________________________________________________________________________________________

_________________________________________________________________________________________________________

_________________________________________________________________________________________________________

_________________________________________________________________________________________________________

_________________________________________________________________________________________________________

_________________________________________________________________________________________________________

_________________________________________________________________________________________________________

_________________________________________________________________________________________________________

II. Information on Father

Full Name: _____________________________________

Year of Birth ____________________

Married___ Divorced__ Widowed___ Deceased____ Year of Death: ________

(Death certificate required)

Current Work Status: Employed___ Retired___ Unemployed___ Self-Employed___

(Wage certificate required)

(Form A required)

If Employed or Retired;

Place of Employment (Name of Organization, Directorate, Company…etc): __________________________________________________________________

Your Current/Last Job Title: ___________________________________________________________________________

Employer Name: ______________________________________________________________________

Employer Address: _____________________________________________________________________

City: _________________ _________________

Country: ______________________________________

Telephone: _____________________________

Mobile Phone:________________________________

Email Address: ______________________________@_________________________________________

III. Information on Mother

Full Name: _____________________________________

Year of Birth ____________________

Married_____ Divorced___ Widowed___ Deceased__ Year of Death: ____________________

Current Work Status: Employed___ Self-Employed__ Unemployed____ Retired_____

If Employed or Retired;

Place of Employment (Name of Organization, Directorate, Company…etc): __________________________________________________________________

Current/Last Job Title: ___________________________________________________________________________

Employer Name: ______________________________________________________________________

Employer Address: _____________________________________________________________________

City: _________________ _________________

Country: ______________________________________

Telephone: _____________________________

Mobile Phone:________________________________

Email Address: ______________________________@_________________________________________

IV. Siblings and Dependents (Do not include yourself in this section)

Siblings at School/University

Name Year of Birth

Name of School Public or Private

Annual Tuition

Parents, all other Siblings and dependents in household

Total number in household (including you)

_____________

Name Year of Relation to Education Job Annual

Birth Applicant

Earnings

V. Financial Information Please list all amounts in US Dollars

**For current students: Please note that any false statement made about your or your family’s finances will result in a strike against you with the Dean of Students. As you know, after three strikes you will be expelled from AUIS.

**For new students/ applicants: Please note that any false statement made about you or your family’s finances will immediately disqualify you from attending AUIS this year and in the future.

Own house? Yes___No__ Rent House? Yes___No____ How much do you pay annually? US$

If you neither own a house nor rent a house, please explain:

Assets

Cash Savings and Securities: US$ Annual Interest US$_________________

Owned Properties:

Location Real Estate Number Area Estimated

Lot Number of Shares (square meters) Present Value

Business (shop,

buildings,

companies…etc)

Home(s)

Land (s)

Total Estimated Value for Owned Properties

All Family Vehicles (including those of applicant)

Owner Make Model/Year Estimated

Present Value

Total Estimated Value for Owned Vehicles

Estimated total value of all assets:___________ US$

Estimated Family Annual Income and Expenses: Income of the family must be specified even if parents are unemployed.

Estimated Total Annual Family Income for 2017:_________ US$

Estimated Total Annual Family Expenses for 2017:_______ US$

VIII. Personal Financial Statement

Please explain in your own words, in 250 words or less, why you believe you need financial aid, including any special family circumstances. You can print what you write and replace it with this page in the form

Documents Required – Checklist

IMPORTANT: Please make sure to submit the following documents with your application or write reason(s) in next page for not submitting document(s), without this your application will be considered incomplete.

1. Employment records: a. Most recent wage certificate(s) for job(s) held by every earning member of the

household clearly stating job title, years of service. It must be official on company letterhead, signed and stamped by the employer. Employer name, address, and phone number must be included.

b. Attached Self-Employed Income Statement (Form A) for each earning member of

the family who is/are self-employed. In addition to documentation required by mentioned form must be submitted.

c. Family members living with applicant, 18 years old or more and unemployed need to bring a notarized declaration letter proving the unemployment status.

2. Applicants must submit copies of recent rental contract(s) and/or ownership deed(s) for each house, plot of land, and business stated in the certificate(s) of ownership. Applicant must also bring a notarized declaration to legally document all properties an assets owned by applicant and family members he/she is living with.

3. Photocopy of vehicle registration form(s) for every car owned by family.

4. Notarized (court-verified) Application. This is an essential step of your application,

which you can complete by taking the completed application to a notary who will verify the

information you provided in your application and stamp it..

5. Bank statement certificate of savings (if any).

6. Photocopy of loan agreement(s), if any, with all supporting documents.

7. Recent school certificate of registration showing annual tuition fees and receipt of fees for each dependent child enrolled at school or university.

8. Copy of household food ration card.

9. Copy of death certificate for deceased parents.

10. Any additional document that would support the Application for Financial Aid.

11. A copy of your TOEFL score if you are a new student.

SIGNATURES

By my signature, I certify that, to the best of my knowledge, the information provided in my

application is accurate and complete.

Signature:____________________________________________ Date:__________________