Scholarship Application Form

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UNDERGRADUATE PROGRAMME
SCHOLARSHIP APPLICATION FORM

PHOTOS

2 recent passport size photos

INSTRUCTIONS:
1. Please read the form carefully and complete the relevant sections; 2. Do not write in the shaded areas.
3. This form should be submitted with:
 A non-refundable fee of $300.00
 Two (2) Passport Size Photographs,
 *Certificates: CXC / GCE, Diploma or Associate Degree (transcripts applicable for tertiary certification)
 *Birth Certificate
 *Marriage Certificate (if applicable),
 An Essay: Why should you be accepted for this programme and how will you use it to your benefit and the wider society
 Two (2) Referee Reports
*copies along with originals should be submitted for verification

[FOR OFFICE USE ONLY]

Id number:
___________________________

PERSONAL DETAILS:
Name: ___________________________________________________________________________ Surname

Christian

Middle

Maiden Name: (where applicable) _______________________________________________

Sex: ☐ Male

☐ Female

Name to be used for official records: _______________________________________________________________________________ Permanent Address: (Home) _______________________________________________________________________________________ ___________________________________________________________________________________________________________________ Mailing Address: (if different from above) ________________________________________________________________________________ ___________________________________________________________________________________________________________________ E-mail address: __________________________________________________________________________________________________ Telephone: (Home) ___________________________ (Work) ___________________________ (Mobile) _________________________ Present Occupation: ______________________________________________________________________________________________ Place of Employment...
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