PROSPECT BURMA 2014 SCHOLARSHIP APPLICATION FORM

for New Applicants who are applying to study in Southeast Asia and Hong Kong This form is for new applicants who are applying to study in Southeast Asia or Hong Kong only. 

If you received a Prospect Burma scholarship for the 2013-2014 academic year and are continuing in the same degree, you should complete the shorter form: "Application for continued funding 2014"



If you are applying to study at a university outside of Southeast Asia/Hong Kong, you should complete the application form: "Application for new applicants wishing to study outside of Southeast Asia/Hong Kong" All forms are available on the Scholarships page at www.prospectburma.org as well as on www.myanmarstudyabroad.org.

Deadline for submission: 28 February 2014 The following documents must be submitted to the appropriate address listed below: L A complete copy of this application form. L Two letters of reference, including at least one academic reference. L Proof of acceptance or enrolment at a university or college, or a letter explaining when you expect to receive such proof L Copy of any letter advising receipt of other scholarships, grants, or financial awards (if applicable) L Copy of academic transcripts (certificates and grade reports) for the highest level of education you have completed L Copy of personal details page of your passport or travel document (if available) L Any additional information you feel supports your application, such as a CV, TOEFL or IELTS transcripts, certificates of completion, etc Applications mailed after 28 February, 2014 will not be accepted.

Submitting your Application Applicants seeking support to study in Southeast Asia or Hong Kong should submit their application form and supporting documents, preferably by email to: [email protected] If email is not available, applicants should mail their application form and supporting documents to: U Soe Lay Scholarships and Student Support, Thabyay Education Foundation, No. 605 (A), San Yeik Nyein 6th Street, Insein Road, Kamayut Township, Yangon Applicants seeking support to study in other regions should not use this application form.

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PROSPECT BURMA Scholarship Application form 2014 For new applicants who are applying to study in Southeast Asia and Hong Kong The free Adobe Reader (version 7.0 or higher) is required to complete this application on your computer. If you do not have this program, you can download it from: http://get.adobe.com/reader/otherversions/.

Answer all questions in English. Applications must be submitted to the address shown in the instructions by February 28, 2014.

PERSONAL (required)

SUMMARY OF YOUR APPLICATION Full Name:

Email: Date of Birth:

Gender:

Ethnicity:

(DD/MM/ YYYY)

OPTION 2

(if applicable)

(required)

OPTION 1

Your Study Options:

University Subject / Major Course Begins*

Level of Degree

Course Ends*

(Month/ Year)

(Month/ Year)

Course Begins*

Course Ends*

University Subject / Major Level of Degree

(Month/ Year)

(Month/ Year)

*This refers to the entire course, not just the current academic year.

FOR OFFICE USE ONLY. DO NOT WRITE ANYTHING BELOW. Completed app. Acceptance Other schol.

HS certificate HS transcript Uni certificate

Uni transcript Academic ref. Professional ref

Registered:

Passport/ID CV/resume English Score

New Student:

Request 1: Request 2:

Yes/No

Previous study report received: Course enrollment confirmed: References: Sent for

Offer of place: Received

Checked

Scholarship C'tee decision: Applicant short-listed: Final decision:

Reject

Accept

Yes/No Amount granted:

Successful applicant notified: Grant letter issued:

Returned signed:

Funds transferred on:

Receipt acknowledged:

Notes:

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1. YOUR PERSONAL DETAILS Full Name:

Aliases (if any)

Ethnicity:

Place of Birth:

Marital Status:

No. of Children:

(Township and State/Division)

Telephone:

Email:

(Country code & number)

Current Residential Address: Permanent Address: Details of your passport or other travel document (if available) Number:

Date of Issue

Date of Expiry

Emergency Contact

Please provide information about a friend or family member who lives close to you and who can easily contact you in the event that we have a problem or concern.

Contact Name: Telephone:

(Country code & Number)

Email: Place of Residence:

2. YOUR FAMILY Father's Name:

Mothers's Name:

Father's Occuption*:

Mother's Occupation*:

Father's Country of Residence:

Mother's Country of Residence:

Name of your siblings: *If either or both parents are retired or deceased, please indicate their previous occupation.

3. YOUR STUDENT STATUS Select one of the following statements which best describes your status as a student: I plan to apply to the university or college listed above. I have already applied to the university or college listed above, but I have not been accepted yet. If you receive the acceptance letter from the university, please send it as soon as possible.

I have been accepted to the university or college listed above, but I have not started classes yet. If you have already been accepted to the university or college listed above, please attach documentation confirming your acceptance.

I am currently attending the university or college listed above. If you are already enrolled and currently studying at the university or college listed above, please attach documentation confirming you are registered as a student.

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Full Name: 4. DETAILS OF YOUR UNIVERSITY, AND COURSE OF STUDY Name of the university or college: Program of study: Mode of Study:

Level of study:

Full-time

Part-time

If you are applying for Graduate study, please briefly explain your thesis plan below.

Detail address of the university or college:

Contact Person

Contact Email

5. PREVIOUS EDUCATION Please attach a copy of your academic transcripts (certificates and grade reports) for the highest level of education you have completed.

High School Education Name of the high school you attended : Year of Examination

Location of your high school:

(Town or Village, Township, State or Division)

Subjects studied: Grades/Scores: Post High School Education Name of learning center/school/university (1): Full Title of Program Studied: Studied to

(Month/Year)

Studied from (Month/Year)

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Completed:

2014

Full Name: 5. PREVIOUS EDUCATION CONTINUED Name of learning center/school/university (2): Full Title of Program Studied: Studied from

Studied to

(Month/Year)

Completed:

(Month/Year)

Name of learning center/school/university (3): Full Title of Program Studied: Studied from

Studied to

(Month/Year)

Completed:

(Month/Year)

Name of learning center/school/university (4): Full Title of Program Studied: Studied from

Studied to

(Month/Year)

Completed:

(Month/Year)

Have you ever taken any official English language examinations, such as TOEFL or IELTS? If yes, what type of exam did you take?

Yes

No

Your score: Date of Exam:

Month:

Year:

6. REFERENCES Please list the names and contact information of two referees who are able to comment on your academic and professional abilities. At least one of these names must be your current or most recent academic supervisor. Please note, your family members, friends, or other students are not eligible to be your referees.

First Referee

Second Referee

Name:

Name:

Position:

Position:

Address:

Address:

Telephone:

Telephone:

Email:

Email:

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Full Name:

7. FINANCIAL INFORMATION PLEASE NOTE: Because Prospect Burma provides only a partial scholarship, you must show evidence of additional funding. In this section, please show all of the financial assistance, assistance in kind (such as free accommodation or food), fee waivers, loans, grants, or discounts you expect to have for the academic year 2014-2015.

Please specify the currency:

Applied for:

Approved:

1. Amount of Other Scholarship or Sponsorship: If you do not have a scholarship or sponsorship, leave this blank.

2. Amount of Fee Waiver: If you do not have a fee waiver, leave this blank.

3. Loans & Grants, including state benefits: If you do not have loans or grants, leave this blank.

4. Income from Part-Time Work: If you do not have income from part-time work, leave this blank.

5. Personal Savings: If you do not have personal savings, leave this blank.

6. Family Contribution: If you do not have a family contribution, leave this blank.

TOTAL PROVIDED BY OTHER SOURCES (Sum of 1 through 6): Prospect Burma only offers partial awards. Please provide any additional information that you feel is relevant to explain how you intend to cover the rest of your expenses?

8. DETAILS OF YOUR BANK ACCOUNT IN YOUR COUNTRY OF STUDY (IF AVAILABLE): SWIFT code*:

Name of Bank and branch address:

Name in which account is held:

Account number:

Bank clearing code (if any)*:

We prefer that you have your own account, but if you use a friend's account, be sure that they agree. *Ask your bank for the codes needed for international bank transfers.

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Full Name: 9. BIOGRAPHY:

In an essay of approximately 500 words in length, give details about your connection to Burma. How long did you live in Burma, and how long have you lived in your present country of residence (if you have already left Burma)? Also, please explain your reasons for choosing your course of study.

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Full Name: 10. FUTURE PLANS: We will give preference to candidates studying subjects that are relevant to the development of Burma. In an essay of 500 words in length, please tell us about your future plans and how you will benefit Burma after graduation.

Full Name:

Today's Date:

If you are awarded a scholarship, we will ask you to sign an undertaking that you will return to Burma to help your country's development.

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prospect burma - Myanmar Study Abroad

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