The Shan Cultural Association in the United Kingdom (SCA-UK) Scholarship Application Form 2013

The following documents must be submitted with the completed application form.

Deadline for submission: 30th April 2013

Evidence of Shan State Nationality ( e.g. Identification Card) Evidence of admission to a University (acceptance letter or student card) A letter of reference ( from Shan Literature and Cultural Association or an academic reference) Copy of academic transcripts (certificates and grade reports) for the highest level of education you have completed Any additional information you feel supports your application, such as CV, achievements/involvement in extracurricular activities, etc

Full name:

Place of Birth:

1. Your Personal Details Gender: Marital Status

Ethnicity:

Current Residential Address:

Permanent Address (if different):

National Identity Number:

Telephone:

2. Your Student Status Select one of the following statements which best describes your status as a student: I have already applied to the university or college, but I have not been accepted yet I have been accepted to the university or college listed above, but have not started classes yet I am currently attending a university or a college University: Subject/Major Title: Level of Degree: Course Begins (Month/Year): Course Ends (Month/Year):

Email:

If you have not received a documentation confirming your acceptance, please send it as soon as possible. The scholarship will be awarded upon the completion of your enrolment into a university.

3. Details of Your University, and Course of Study Name of the university or college: Contact Person (Enrolment Officer/ Administrator): Address of the university: Telephone (if applicable):
2

Email (if applicable):

What is the full title of your programme of study? Select one that best describes your course: Full-time Part-time Distance education Name of the high school you attended: High school subjects studied:

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

4. Previous Education

Matriculation Grades

Location of your high school:

Year of Examination

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.

Name:

First Referee

5. References Name:

Second Referee

Address:

Address:

Telephone: Fax: Email:

Telephone: Fax: Email:

Please note: Because SCA-UK 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 2012-2013.

Course Fees:

6. Course Fees and Financial Information

Accommodation Fees: Other Expenses:

Amount of other Scholarship:

Loans & Grants, including state benefits: Income from Part-time Work: Personal Savings: Family Contribution:

If you do not have other scholarship, leave this blank

If you do not have loans or grants, leave this blank

If you do not have part-time work, leave this blank

If you do not have personal savings, leave this blank

If you do not have family contribution, leave this blank

In an essay of 500 words maximum, please tell us in your own words, about your skills and achievements, hobbies and interests, work experience, extracurricular activities and your future career and plans. Please use additional sheet if required with your full name stated clearly at the top of each additional sheet used. (either in Shan, Burmese or English)

7. Personal Statement

I guaranteed that all the above information are correct and genuine to my best knowledge.
If you are awarded a scholarship, you are required to provide study report to (SCA-UK) at the end of your academic year. Please also note that a study report has to be submitted prior to application for continued funding.

Full Name: Signature:

Date: