MINISTRY OF EDUCATION

GOVERNMENT OF THE REPUBLIC OF KIRIBATI

PRE SERVICE SCHOLARSHIP APPLICATION FORM 2017 To be completed by eligible Kiribati citizen (residing in Kiribati) or of Banaban origin (residing in Fiji) seeking scholarship from the Government of the Republic of Kiribati

Read carefully the instructions below before completing and submitting this form 1.

Answer all questions by filling in and circling accordingly

2.

Type or PRINT your answers

3. Eligibility: i) Kiribati Citizens residing in Kiribati or in Fiji (for Banaban) at the time of application ii) Must be in Form 7 during the year of application iii) Must be 21 years old and younger by 1st January, 2018

4.

An incomplete application form will not be considered

5. The application will be deemed incomplete if it is submitted: (i) without official certified photocopies by Court of the following: a) Academic certificates which must include subject grades. (KNC & KSSC or Preliminary) b) Birth certificate (ii) without official endorsement by Rabi Council (in the case of students of Banaban origin holding Fiji passport) The above supporting documents must be certified as true copies of original documents with the official stamp and signature of a Justice of the Peace.

6.

End of year academic results must be submitted as soon as available to Scholarship Unit before/by 15th December 2017.

7.

Completed forms must be submitted to: Scholarship Unit Ministry of Education P O Box 263, Bikenibeu, Tarawa Republic of Kiribati

8.

E –Copy of completed forms are not accepted.

9.

Application forms need to be received at the above address before or on Thursday 27th April 2017 at 3pm.

NAME OF APPLICANT:

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For Official Use Only DATE RECEIVED:

A.

PERSONAL DETAILS

1. First Name: ……………………………………………. 2. Surname: ……………………………………………… 3. Sex:

Male

Female

4. Date of Birth: ……/………/…….. (dd/mm/yy) 5. Religion: ……………………….. 6. Email/Phone number: …………………………………….......... 7. Home Island: ………………………………… 8. Address (The scholarship application process takes several months. Please give an address where you can be contacted when a decision is finalized.

B. PROGRAMME (Refer to Human Resource Development Needs/National Priority List for 2017) Choice 1st 2nd

C.

Programme (BSC,BCom, orBA)

Majors/Minor

EDUCATION BACKGROUND

1. Form 5 Examination: Name of Exam: …………………………………… School: …………………………………………….. Subjects

Year of Examination: …………… Grade

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2. Form 6 or Equivalent Examination: Name of Exam: ………………………………….. School: ……………………………………………. Subjects

Grade

Subjects

3. Form 7 or Equivalent Examination: Name of Exam: …………………………… School: ……………………………………. Subjects

Grade

Year of Examination: …………… Grade

Year of Examination: ……………… Subjects

Grade

4. Are you undertaking any study for which results are not yet available? YES/NO If yes, name the Examination; ………………………………………………………

D. REFEREES Give the full name of two persons who are willing to make a written testimony to your academic. Give their full contact address including telephone or email addresses. 1. 2.

E. APPLICANT’S DECLARATION I certify that the statements made by me in this application are true and complete to the best of my knowledge. I also understand that the Ministry reserves the right not to consider this application should any statement be false or should certified copies of the following are not attached.  

Academic certificates and result slips. Birth Certificate

Full Name: …………………………………………………..

Signature of Applicant: ……………………………………. Date: …………………………….

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