HOPES scholarship program for graduate studies funded by the EU 'Madad Fund' Application Form Please note: You may only submit ONE application Instructions: 1.

Complete all parts of the application in ENGLISH.

2.

Place X in the appropriate blank provided.

Application Ref. No. ____________(for internal use only).

Date: _________________________ UNHCR Asylum Seeker Certificate No./Proof of Registration No. ________________________________ UNHCR Individual No. __________________________ Ministry of Interior (MoI) card No. __________________________

I.

Part I - Applicant’s Personal information Full Name: ___________________ ____________________ __________________ __________________ (First Name) Gender:

(Second Name)

Male

(Third Name)

(Family Name)

Female

Place and Date of Birth: _______________ __________________ (Country)

(Town or Village)

____

_____ _______

(Day) (Month) (Year)

Nationality: ___________________ Marital Status:

Single

Married

Divorced

Widowed

Current Residential Address: _______________________________________________________________________________________ E-mail address: ___________________________________ Mobile Phone No: __________________

Other Mobile No: ___________________

Family Background >

Father’s occupation (in Syria before the war and now): _______________________/___________________

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Mother’s Occupation (in Syria before the war and now):_______________________/___________________

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Father’s country of residence: ___________________

Mother’s country of residence: _____________

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Average family monthly income: ______________________

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How much are you paying monthly for residence (if applicable)? ___________________

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Number of siblings in the family (including applicant): ______

Please fill out information below about your siblings / spouse if married or other dependents: Name

II.

Age

Relationship

Educational Degree Achieved up to date.

If working, indicate where they work and their average monthly income

Part II – Previous Education 1.

High School:

Name of High School Graduated from: ______________________________________________________ Public

Private

Country of High school: ______________ High school certificate Stream: _____________ High school GPA/Rate: ___________ 2.

Universities or institutions attended:

Graduation Year: ________

Name of University

3.

Country

No. of years or credit hours completed

Field of study

Degree obtained

Overall grade

Languages:

Please rate as: E = Excellent, G = Good and F= Fair. Mother tongue _____________________

Read _____

Write Speak _____

______

Other languages

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______________________

_____ _____

______

______________________

_____ _____

______

______________________

_____ _____

______

Have you completed any English courses? If so, please state where, when and for how long: ________________________________________________________________________________________ ________________________________________________________________________________________

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Have you taken the National English Language Exam (NELT), TOFEL, IELTS in the past two years? If so, please indicate the exam and the score you have achieved. __________________________________________________

III.

PART III – Previous employment experience: Please list all previous or current employments you have had, beginning with the most recent.

Name of company/institute/ Other

Title of position

Country

Attended From/To Mo./Year Mo./Year

Salary Per Month

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Voluntary work experience:

Name company/institute/ other

IV.

Title of position

Country

Duration (from – until)

PART IV – PLANNED EDUCATION *The HOPES scholarship program covers two years of Master’s degree. Have you received an official acceptance letter from the designated university for the Master’s program for the upcoming academic year 2017-2018? ________________________ Length of time expected to complete program of study in years: _____________ Please specify the university and major in which you would like to pursue your master degree: (the priority will be given to the mentioned universities in the table)

University Hashemite University

Priority Majors 1. ______________________________________________________ 2. ______________________________________________________ 3. ______________________________________________________

University of Petra

1. ______________________________________________________ 2. ______________________________________________________ 3. ______________________________________________________

Zarqa Private university

1. ______________________________________________________ 2. ______________________________________________________ 3. ______________________________________________________

German Jordanian University

1. ______________________________________________________

(Except MBA)

2. ______________________________________________________ 3. ______________________________________________________

Al Zaytooneh Univesity

1. ______________________________________________________ 2. ______________________________________________________ 3. ______________________________________________________

Al- Albayt University

1. ______________________________________________________ 2. ______________________________________________________ 3. ______________________________________________________

Other, Please specify:

1. ______________________________________________________ 2. ______________________________________________________ 3. ______________________________________________________

Essay Question: Please state in a few lines the reasons why you want to pursue a Master’s degree in the proposed field of study (be as specific as possible): ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________

____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ ________________________

Documents needed to be attached to the application in order for it to be considered for review: A recent photograph. A copy of the passport. A photocopy of UNHCR registration card. A copy of your High School Diploma. A photocopy of Bachelor degree transcript and graduation certificate. A copy of the approval letter from the Syrian embassy which was submitted to the designated faculty of study.

Note: You are not eligible to apply to the HOPES program if you have been awarded another scholarship.

I certify that my statements in response to the foregoing questions are true, complete and accurate to the best of my knowledge and belief and I understand that false information given in this application will affect my chances of selection and continued sponsorship. Signature of applicant:

_________________________________________