SHELL MALAYSIA 2014 SCHOLARSHIP APPLICATION FORM

Confidential
CLOSING DATE: 28th February 2014
IMPORTANT INFORMATION
1.

The scholarship is awarded to Malaysian students who intend to pursue/Pursuing full-time undergraduate studies
tenable at recognized universities in Malaysia or abroad.
2. Students who have completed their STPM/A-Level/Foundation Year/Diploma or currently in their final semester of
Matriculation studies are eligible to apply.
3. Please complete the form digitally.
4. Incomplete and late application will be rejected.
5. If you do not receive any reply from us by 30 April 2014, your application is therefore considered unsuccessful.
6. *Please delete whichever is NOT applicable.
This Scholarship Application Form should be submitted online via the Shell Malaysia Online Application website on
www.shell.com.my/scholarship-application
CHOICE OF STUDY
Choose (one) either Overseas or Local Scholarship only.
Not allowed to apply for both Overseas and Local.
a) Overseas
Technical:
Petroleum Engineering

Mechanical Engineering

Geosciences

Others: __________________ (Specify)

At which university? ___________________________ (Specify)

b) Local (Malaysia)
Technical:
Petroleum Engineering

Mechanical Engineering

Geosciences

Others/Commercial: __________________ (Specify)

At which university? ___________________________ (Specify)
WHY HAVE YOU CHOSEN THIS CHOICE OF STUDY?
Make a brief statement, of not more than 200 words, of your choice as they relate to your aspirations, career objectives and
long term goals.

1.

PERSONAL PARTICULARS

Name

(as per your MyKad)

NRIC No.
Age:
State of origin: Peninsular Malaysia/Sarawak/Sabah
Combined Family income
(in RM per month)
Family Income statement
(Are there any unusual family circumstances you want considered as part of your application? Max 100 words)

Any physical disability (eg. sight, hearing, speech) :

2. ACADEMIC RESULTS
Page 1/2

Any previous illness/operation :

Please state your specific academic subjects plus exact grade (A+, A-, C+ etc) from STPM/A-level onwards to the highest level
of study achieved to date

3. EXTRA CURRICULAR ACTIVITIES

CLUBS/SOCIETIES/OTHERS
YEAR
e.g. 2012 2013

REPRESENTED

ACTIVITIES
e.g. - Interact Club Swimming

REPRESENTED :
POSITION HELD :
Secretary;

e.g. - National

POSITION HELD
(Please refer to the list below)
e.g. - President

House; School; District; Division; State; National

Chairman; President; Vice/Dep. President/Chairman; Captain/Leader; Treasurer; School Prefect;

Assistant; etc.
4. SPECIAL AWARDS RECEIVED
YEAR
TYPE OF AWARDS

GRANTED/SPONSORED BY

5. OTHER FINANCIAL INFORMATION

Are you currently receiving any financial assistance or sponsorship from other institution, fund or foundation? YES/NO* If YES,
please give details:
Institution/Fund/Organization/Foundation (e.g. JPA, MARA, PETRONAS, PTPTN,
Year
Amount (RM)
etc.)
1)
2)
3)
6. RECOMMENDER
Provide name and contact information of a teacher, counselor, instructor or work supervisor
Name:
Role:
Contact info:

Page 2/2