CARRERAS 2015/2017 POST GRADUATE SCHOLARSHIP APPLICATION FORM Read carefully and complete all sections of this form as applicable HIGHER SECTION A – CONTACT INFORMATION 1. First Name: ______________ 2. Sex: M  3. Nationality: ____________________________ 4. Parish of Birth: _________________________ 5. Address: ______________________________________________________________________ F Middle Name: _______________ Age: ____________ Surname: _______________ Date of Birth: ______/______/_________ DD MM YYYY ______________________________________________________________________________ 6. Mailing Address (if different from above): ___________________________________________ ______________________________________________________________________________ 7. Home Number: _______________________ 8. Email Address: _________________________________________________________________ Cell Number: ___________________________ ______________________________________________________________________________ SECTION B – DETAILS OF PROGRAMME 1. Name Institution/University you are currently enrolled in ………………………………………… 2. Course of study: ………..............................………………………………………………………. 3. Duration of study: …............................……………………………………………………………. Have you previously been awarded any scholarship or bursary in connection with your present course of study? Yes [ ] No [ ] - If yes, please supply details: 4. ….. ………………………………………………………………………………………….. ………………………………………………………………………………………………. 4.1 How are you presently being supported with your college expenses? Student Loan [ ] Other Boarding Grant [ ] Parental Support [ ] [ ] please state ………………………………………………………… SECTION C - YOUR EDUCATION (INCLUDING TRAINING COURSES) 5. Undergraduate Qualifications (all applicants) a) Please give details of your undergraduate qualifications including Honours and attach originals (or certified copies* of) Transcripts giving subject details and results. Qualification Level of Qualification Level of Honours Institution/ Duration of study Completed Yes/No Obtained University and Location SECTION D – LEADERSHIP & VOLUNTEERISM 1. List any leadership positions or offices held during your educational/or professional career: …………………………………………………………………………………………………………... …………………………………………………………………………………………………………... 2. List any clubs or societies that you have been a member of during your educational/or professional career: …………………………………………………………………………………………………………... …………………………………………………………………………………………………………... 3. Have you participated in community/voluntary service? Yes [ assistance did you provide and when? ] No [ ] - If yes, what kind of Date:_____________________ …………………………………………………………………………………………………… …... …………………………………………………………………………………………………………. SECTION E – REFERENCES 1. Please give the names of two referees, preferably persons who have taught or worked with you. a. Name: ________________________________________________ Position: __________________________ Institution: ______________ Address: ___________________________________ Tel: ________________ b. Name: _________________________________________________ Position: ___________________________ Institution: _________________ Address: __________________________________ Tel: ________________ 2. State, in no more than 200 words, your career goals and the benefits you hope to gain from successful training. ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ 3. ___________________________________ (Attach additional page, if necessary) Any other information which you consider relevant to this application: ______________________________________________________________________________ _____________________________________________________________________________________________ ___________________________________________ (Attach additional page, if necessary) Statistical information (scholarship applicants) Where did you hear about the scholarships? On-campus: _______________________ Newspaper:-_________________________ Previous Scholarship Awardee: ______________________ Other : __________________ Application Checklist In order to expedite your application, please ensure that the following checklist is complete prior to the submission of your application. 1. ONE copy [certified] of your official academic transcript, showing academic background (at least an Upper Second Class degree or equivalent at the time of application) and Extra-Curricular activities at university level 2. Statement of purpose of study 3. Evidence of acceptance for postgraduate studies at a college/university 4. ONE copy (certified) of your birth certificate, or other document showing evidence of age and nationality (Passport or Driver’s Licence) 5. ONE copy of your resume 6. TWO Letters of reference Signature: ________________________________________ Date: ________________________________________ This Application Form can be returned to: Carreras Limited 13a Ripon Road Kingston 5