Application Form for theHOPES scholarship program
Please note: You may only submit ONE application –in hardcopy!
Instructions:
1-Complete all parts of the application inENGLISH. Application Ref. No. ______(for internal use only).
2-Place X in the appropriate blank provided.
Date: ------
UNHCR Asylum Seeker CertificateNo./Proof of Registration No. ______
Ministry of Interior (MoI) card No.______
PartI – Applicant’s Personal information
Full Name: ______
(First Name) (Second Name) (Third Name) (Family Name)
Gender: Male 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 in Egypt): ______/______
Mother’s Occupation (in Syria before the way and now in Egypt): ______/______
Father’s country of residence: ______Mother’s country of residence: ______
Average family monthly income: ______
How much are you paying monthly for residence (if applicable)? ______
Number of siblings in the family (including applicant): ______
Please fill out information below about your siblings/ spouse if married or other dependents:
Name / Age / Relationship / Educational Attainment / If working, Indicate where they work and their average monthly incomePart II – Previous Education
High School:
Name of High School Graduated from: ______Public Private
Country of High school: ______
High school certificate Stream: ______Graduation Year: ______
High school GPA/Rate: ______
Universities or institutions attended:
Name of University / Country / No. of years or credit hours completed / Field of study / Degree obtained / Overall gradeLanguages:
Please rate as: E = Excellent, G = Good and F= Fair.
Mother tongue Read Write Speak
______
Other languages
______
______
Have you completed any English courses? If so, please state where, when and for how long:
______
PART III – Previous employment experience:
Please list all previous or current employments you have had, beginningwith the most recent.
Name of company/institute/other / Title of position / Country / Attended From/To / Salary Per Month
Mo./Year / Mo./Year
Voluntary work experience:
Name company/institute/other / Title of position / Country / Duration
(from – until)
PART IV – PLANNED EDUCATION
*The HOPES scholarship program covers two years of Master’s degree.
Proposed field of study:
Have you received an official acceptance letter from thedesignated university for the Master’s program for the upcoming academic year 2016-2017?
Length of time expected to complete program of study in years: ______
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 ofBachelor degree transcript and graduation certificate.
A copy of the approval letter from the Syrian embassy which was submitted to the designated faculty of study.
An original letter from the university which indicates that you were registered for the Master’s program during the academic year2015-2016and it should provide information on your academic progress during the academic year 2015-2016.
An original letter which states that you are registered for the academic year 2016-2017 and the expected tuition fees.
A photocopy of UNHCR registration card.
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:
______
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