Application Form

Transcription

Application Form
New Zealand
SCHOLARSHIPS
Application Form
New Zealand ASEAN Scholars Awards
New Zealand Pacific Scholarships
New Zealand Development Scholarships
Commonwealth Scholarships
www.aid.govt.nz/schols
NEW ZEALAND SCHOLARSHIPS
New Zealand Scholarships empower individuals with the knowledge, skills and qualifications to contribute to
economic, social and political development within selected developing countries. They are funded through the
New Zealand Aid Programme and managed through the New Zealand Ministry of Foreign Affairs and Trade.
Scholarship recipients are required to return to their home country on completion of their scholarship to
work for a minimum period of two years in order to apply their new skills and knowledge.
APPLICATION CHECKLIST
It is important that you correctly fill out all relevant sections in this application form and include all relevant
documents listed below. Applications with unanswered questions or incomplete documentation will not be
considered for a scholarship.
Supporting documents provided with this application must be certified true copies of original documents with
the official stamp and signature of a Justice of the Peace, Solicitor, Notary Public, an official from the New
Zealand Diplomatic Post, or another authorised official. Where original documents are not in English, you must
provide certified true copies of official English translations.
All New Zealand Scholarship award applicants must provide TWO copies of this application form (one
original copy and one photocopy), completed in English. Each copy of the application form must include:

A signed application Declaration on page 12.

A certified copy of your birth certificate (in English).

A certified copy of official evidence of any name change (in English).

A certified copy of the personal pages of your passport.

For applicants applying for undergraduate study only (where eligible), a certified copy of your official
secondary school results and the grading schedule for each qualification (in English).

For all applicants applying for postgraduate study, a certified copy of the academic transcript for all
tertiary qualifications and the grading schedule for each qualification (in English).

A certified copy of the completion or graduation certificate for each tertiary qualification that you have
completed (in English).

The original international English proficiency test result, e.g. IELTS or TOEFL, or selection of one of the
valid reasons for not providing the results as listed in Section Eleven on page 10. Photocopies will not be
accepted. Test results must be no more than 24 months old by the commencement of study.

If you are employed, a current job description confirming your position and outlining your
responsibilities and duties.

A current (dated) curriculum vitae - a brief history of your education, work experiences and skills.

Three references (no more than 24 months old) on official letterhead, supporting your scholarship
application to study in New Zealand. References should be provided from your current employer and a
former lecturer (or school principal for undergraduate applicants), and where possible, a relevant
government or community-based organisation.

A 500 word statement describing the specific skills and knowledge you want to gain from your proposed
study and how this will contribute to your current and/or future job.

A 500 word statement describing how your proposed area of study will enable you to contribute to the
social or economic development of your home country.

For Masters and Doctoral research students, a 500 word statement outlining your proposed research topic.
Do not send in an application without all the required documentation
FURTHER INFORMATION
Information on the New Zealand Scholarships including eligible countries, the application process, deadlines,
priority subject areas, and the list of participating New Zealand education institutions is available on the
scholarships pages of the New Zealand Aid Programme website: www.aid.govt.nz/schols
www.aid.govt.nz/schols
New Zealand Scholarships Application Form | Page 2
SECTION ONE: SCHOLARSHIP TYPE




Which scholarship are you
applying for? (tick one)
New Zealand Pacific Scholarship
New Zealand ASEAN Scholars Award
New Zealand Development Scholarship
Commonwealth Scholarship
For information about which
scholarship to apply for, visit
www.aid.govt.nz/schols
SECTION TWO: PERSONAL INFORMATION
Please note that your family name and other names should be the same as the official names
on your passport or birth certificate.
First name(s)
Attach a recent passport
sized photograph of
yourself
Family name (surname)
 Male
Gender
 Female
Date of birth
(dd/mm/yyyy)
Place of birth
Country of citizenship
Please list second country
if you have dual
citizenship
nd
2 country of citizenship
Do you have permanent
residency status in any
other country?
 Yes
Have you applied for
permanent residency status
in any other country?
 Yes
 No
If yes, please list:
 No
If yes, please list:
Passport number
Passport expiry
Do you suffer from any illness or disability that might affect your ability to participate
in the proposed study programme (for example, psychiatric condition, asthma,
diabetes, significant visual impairment, motor disability or significant hearing loss)? A
‘Yes’ answer will not affect your chances of successfully obtaining a scholarship.
 Yes
 No
If you have answered ‘Yes’, please provide brief details of the illness or disability and any special requirements
or support you may require to complete your study programme on a separate sheet of paper. Please attach a
copy of your doctor’s assessment of your needs.
Applicant contact details: The scholarship application process takes several months. Please give an address
where you can be contacted when a decision is reached. You may not be offered a scholarship if you cannot be
contacted.
Number and street name
PO Box number
Suburb/village
Town/city
District/Province
www.aid.govt.nz/schols
New Zealand Scholarships Application Form | Page 3
Country
Post Code
Home telephone number
Work and/or cell-phone
number
Email address (enter more
than one if relevant)
Emergency contact details: Name someone we can contact in an emergency during your study in New Zealand
Name
Relationship to you
Number and street name
Suburb/village
Town/city
Country
Post Code
Home telephone number
Work and/or cellphone
number
Email address
SECTION THREE: DEPENDANTS
In order to qualify for a reunion airfare or to have your dependants accompany you to New Zealand, you must
complete the information below.
Please note that the scholarship does not provide financial support for your dependants.
Please attach a separate sheet of paper if you have additional dependants to those below.
If you intend to have your dependants accompany you on scholarship to New Zealand, please note the following:
1. You are responsible for supporting your dependants for the duration of their stay in New Zealand.
2. Family entry is subject to meeting Immigration New Zealand’s entry requirements.
3. Spouses/partners may apply for a non-labour market tested work permit.
4. Dependant school aged children have domestic access to New Zealand schools.
5. Families have access to the New Zealand health system as if they were New Zealand citizens.
Family status
 Single
 Single with children
 Married
 Engaged
 De facto relationship / have a partner
Dependants details (Dependants are defined as the Awardee’s spouse (if legally married) or partner (if in a defacto relationship), and children under 19 years of age)
Full name (first & family)
www.aid.govt.nz/schols
Gender
(M/F)
Date of birth
Relationship
Do you intend for them to
join you in NZ? (tick one)
 Yes
 No
 Yes
 No
 Yes
 No
 Yes
 No
New Zealand Scholarships Application Form | Page 4
SECTION FOUR: PROPOSED STUDY PROGRAMME
 List your first and second choice of qualification that you want to study in New Zealand.
 The education institution must be one of the institutions listed in Annex 2 (page 13).
 The qualification and major listed must be currently available at the institution. Please check the institution
website or contact the institution for an up to date list of their qualifications (Refer to Annex 2 for website
information).
 Refer to www.aid.govt.nz/schols to find out the priority subject areas for your country.
 Choose carefully as if you are awarded a New Zealand Scholarship, you will not be permitted to make changes.
First Choice Qualification
Major Subject/s
Education Institution
Second Choice Qualification
Major Subject/s
Education Institution
Use the table in Annex 1 (page 13) to identify one employment sector most similar to your intended area of
work upon completion of your study, and list below.
Employment sector
(from the list in Annex 1)
If there are no employment sectors in Annex 1 that are relevant to your intended area of work, please state
your specific sector here:
SECTION FIVE: CURRENT STUDY
 Working (full-time)
List your current
occupation (if ‘working’ or
‘not studying or working’ is
selected, go to Section Six)
If you are studying now, list
the level at which you are
studying
 Working (full-time) and studying at
tertiary level (part-time)
 Working (full-time) and studying at
tertiary level (full-time)
 Studying at tertiary level
 Studying at secondary school
 Not studying or working
 Secondary school
 University foundation
year
 Tertiary training /
technical certificate
 Undergraduate
diploma
 Bachelors degree
 Postgraduate
diploma
 Masters degree
 Doctorate (PhD)
Qualification name
Major subject(s)
Start date
Proposed end date
Length of qualification
Education institution name
www.aid.govt.nz/schols
New Zealand Scholarships Application Form | Page 5
Institution location
(town/city and country)
 Yes
Are you on a scholarship now? If yes, complete details below
 No
Sponsor name
Scholarship name
SECTION SIX: STUDY HISTORY
For each previous qualification you must also include with this application:
 A certified copy of the complete academic transcript (mark sheets); and
 A certified copy of the completion certificate
Provide the following information for all completed and partially completed tertiary or vocational qualifications.
Undergraduate applicants must also provide information about senior secondary qualifications.
List the most recently completed qualification first.
Qualification
Major subject
Education institution
Institution location
Start date (month/year)
End date (month/year)
Qualification
Major subject
Education institution
Institution location
Start date (month/year)
End date (month/year)
Qualification
Major subject
Education institution
Institution location
Start date (month/year)
End date (month/year)
List any of the qualifications that have been studied by
distance education
List details of any relevant academic distinction or prizes
List any scholarships you have
previously received, including
any funded by the New Zealand
Government.
Include the scholarship name,
duration, qualification or
course undertaken and the
date completed.
www.aid.govt.nz/schols
New Zealand Scholarships Application Form | Page 6
SECTION SEVEN: WORK HISTORY
If you are currently employed or have recently been employed:
 Answer the questions in this section, and
 You must also include an up-to-date curriculum vitae and current job description with this application.
If you are not currently employed and have no previous work experience, go to Section Nine.
Current/most recent
position title
Organisation
Start date (month/year)
If you are employed now, refer to the list in Annex 1 (page 13) to identify up to two employment sectors most
similar to your current area of work, and list below:
Employment sector
(from the list in Annex 1)
If your employment sector is not listed in Annex 1 (page 13) please state your employment sector here:
What type of organisation
do you work for?
 Local Government
 Community/NonGovernment
Organisation
 Private company
 Central Government
 International NGO
 Self-employed
 Multilateral Agency
 Other (please state):
Briefly describe the work
of your organisation.
Will you return to your
current job after your
study?
 Yes
 No
If you answered ‘no’ or you are not currently working, what is your prospective employment on your return home?
Name of Job
Organisation
www.aid.govt.nz/schols
New Zealand Scholarships Application Form | Page 7
SECTION EIGHT: EMPLOYER ENDORSEMENT
 If you are working, this section must be completed (in English) by your employer or an authorised officer
from your place of employment, or
 If you are self-employed, you may answer the questions yourself.
Name of company/
organisation
Address
Telephone Number
Email address
Do you endorse and support
this applicant’s application for
a New Zealand Scholarship?
 Yes
 No
Are there any comments you
would like to make in support
of this application for a New
Zealand Scholarship?
After the scholarship is completed would this person have a position in your organisation?
 Yes
 No
If yes, what position:
Describe below the specific skills and knowledge you and your organisation want the applicant to gain from the
proposed study. Please be as specific as possible.
Skills and knowledge 1
Skills and knowledge 2
Skills and knowledge 3
Skills and knowledge 4
Authorising official’s full
name
Position
Signature
Date (dd/mm/yyyy)
Official Stamp
www.aid.govt.nz/schols
New Zealand Scholarships Application Form | Page 8
SECTION NINE: COMMUNITY EXPERIENCES
List any voluntary or community activity in which you have recently been involved. Please attach an additional
sheet of paper if required.
Organisation
Role or type of
involvement
Start date (month/year)
End date (month/year)
Organisation
Role or type of
involvement
Start date (month/year)
End date (month/year)
SECTION TEN: RELEVANCE OF STUDY TO DEVELOPMENT OF YOUR HOME COUNTRY
Please be as specific as possible as your answers to these questions will be a major consideration of your
eligibility for a New Zealand Scholarship.
All applicants:
You must include with this application:
 In no more than 500 words (on a separate sheet of paper) describe the specific skills and knowledge you
want to gain from your proposed study and how this study will contribute to the role and responsibilities of
your current and/or future job;
and
 In no more than 500 words (on a separate sheet of paper) describe specifically how your proposed study
and/or research will enable you to contribute to the social or economic development of your home country.
Reference to any existing national skills shortages or labour needs in your home country will strengthen your
application.
Research Masters and PhD applicants:
You must also include with this application:
 In no more than 500 words (on a separate sheet of paper) provide an outline of your proposed research
topic, research question and objectives, methodology, and timeline. Note that most PhD and some Masters
research students will be expected to undertake fieldwork in their home country (funded by the scholarship).
You should clearly demonstrate the significance, benefit and application of the proposed research topic to the
development of your home country.
www.aid.govt.nz/schols
New Zealand Scholarships Application Form | Page 9
SECTION ELEVEN: ENGLISH LANGUAGE COMPETENCY
You must include with this application:
 Original IELTS (International English Language Testing System) results. Test results must be no more than 24
months old by the commencement of study;
Or
 Original copy of TOEFL (Test of English as a Foreign Language) results. Test results must be no more than 24
months old by the commencement of study;
Or
If you are not providing IELTS/TOEFL results please advise the reason:
 I have sat an IELTS or TOEFL test and am awaiting results. I will supply the results as soon as they
are available.
 IELTS or TOEFL testing is not available in my region or country (Pacific Islands only).
 I have previously completed tertiary education in English AND I have included an official statement
from the education provider that English is the language of instruction.
Note that you are also required to meet the English language proficiency criteria of the education institution
you are applying to. They may request additional documentation.
Is English your first
language?
 Yes
 No
Include details below of any IELTS (International English Language Testing System) academic tests you have
undertaken. Please also include the original results with this application.
IELTS date of test
IELTS overall score
IELTS listening band
IELTS reading band
IELTS writing band
IELTS speaking band
Include details TOEFL (Test of English as a Foreign Language) test you have undertaken. This should be EITHER
an Internet-based TOEFL score OR a Paper-based TOEFL score. Please also include the original results with this
application.
Test of Written English
(TWE) score
Paper-based TOEFL
score
TOEFL date of test
Internet-based TOEFL score
Have you been taught in
the medium of English?
 Yes
If ‘yes’, tick the boxes at the
level you have been taught
in English
 Senior secondary
school
www.aid.govt.nz/schols
 No
 Undergraduate or
postgraduate level
 While training for
my job
New Zealand Scholarships Application Form | Page 10
SECTION TWELVE: WHERE YOU HEARD ABOUT THE NEW ZEALAND SCHOLARSHIPS
Tick the box that most accurately represents where you first heard about the New Zealand Scholarships:















The New Zealand Aid Programme website (www.aid.govt.nz)
Event attended or hosted by the New Zealand Embassy or High Commission in your country
From information about studying in New Zealand from The New Zealand Embassy or High Commission
Website/blog of the New Zealand Embassy or High Commission in your country
Social media (such as a New Zealand Embassy or High Commission Facebook page)
A New Zealand university
A school or university in your country
Newspaper
Online advertising
Employer – private sector
Employer – government sector
Business association
Education agency
Friends or family
Other (please state):_____________________________________
SECTION THIRTEEN: NEW ZEALAND SCHOLARSHIP CONDITIONS AND DECLARATION
Conditions of Scholarship
If your application is successful and you are offered a New Zealand Scholarship, you will be asked to sign a
declaration which confirms that you understand and agree to certain conditions before accepting the
scholarship. Some of these conditions are listed below. Contact the New Zealand Embassy or High Commission
for a full listing of these conditions.
In accepting, you will be asked to:

agree to undertake the study programme included in the Letter of Scholarship Offer full time and
understand that this must not be changed without the prior written approval of MFAT;

agree to make every effort to achieve satisfactory academic progress in your studies in accordance with
the continuation criteria set by MFAT and the Education Institution;

agree that you will return to your home country within 14 days completion of your study programme
and return directly to your home country for a minimum period of two years, in order to utilise the
knowledge you have gained through your scholarship to contribute toward the social and/or economic
development of your home country;

agree that your spouse/partner and dependant children (if relevant) will return to your home country
within 14 days of completion of your study programme and return directly to your home country for a
minimum period of two years;

agree that you and your spouse/partner and dependant children (if relevant) will not apply for a visa
(excluding a short term visitor visa) to re-enter New Zealand within two years of scholarship completion;

agree that you will not apply for permanent residency of any country including New Zealand during the
scholarship period or within two years of scholarship completion;

agree to obey the laws of New Zealand and maintain an acceptable standard of conduct while in New
Zealand;

agree that the New Zealand Government is not responsible for any of your actions during the term of
your scholarship;

agree to ensure your immigration visa and passport are kept current for the duration of the scholarship.
www.aid.govt.nz/schols
New Zealand Scholarships Application Form | Page 11
Declaration
I confirm and declare that:
1.
I am not aware of any medical, personal or other circumstances (e.g. disability, illness, family or
financial matters), which might prevent me from completing my study within the scholarship term;
2.
I agree to the release of information in this application form and information relating to the
scholarship or study to relevant authorities, in accordance with the New Zealand Privacy Act 1993, to
enable placement in an education institution, consideration for a scholarship, collection of academic
progress reports and results, and the ongoing administration and monitoring of the scholarship;
3.
I agree to the exchange of information between MFAT and authorities such as Immigration New
Zealand (regarding your immigration status) or any other relevant government agency (e.g. New
Zealand Inland Revenue or the New Zealand Qualifications Authority);
4.
I understand that the law of New Zealand will apply to any agreement between myself and the New
Zealand Government.
I declare that the information provided about and by me in this application for a New Zealand Scholarship
award is true, complete and correct to the best of my knowledge. I acknowledge that supplying false or
misleading information is a serious offence under the New Zealand Crimes Act 1961 and will result in the New
Zealand Ministry of Foreign Affairs and Trade (MFAT) withdrawing a scholarship, if offered.
Full Name
Signature
Date
dd/mm/yyyy
www.aid.govt.nz/schols
New Zealand Scholarships Application Form | Page 12
Annex 1
Employment Sectors
Use this information to complete:
 Section Four: Proposed Study Programme, and
 Section Seven: Work History
Note that:
 Scholarships are awarded in the subjects that are a priority for each country.
 Not all subjects are available for all countries.
 Refer to www.aid.govt.nz/schols to find out the priority subject areas for your country.
Agriculture (including Agribusiness & Animal Health)
Business (private sector)
Diplomacy / Foreign Affairs
Disaster Risk Management
Education – Primary/Secondary
Education – Tertiary
Economics
Engineering
Environmental/Natural Resource management
Finance
Fisheries/Marine Resources
Food Safety
Annex 2
Forestry
Health
Human Rights / Gender
Information Technology
Public Sector Management/Governance
Public Utilities and Infrastructure
Renewable Energy
Skilled trades (plumbing, electrical, construction)
Tourism
Trade
Urban Planning and Development
Waste Management
Education Institutions
Use this information to complete Section Four: Proposed Study Programme
Note that:
 Scholarships are only available for study at the institutions listed below.
 Scholarships are awarded in the subjects that are a priority for each country.
 Not all subjects are available for all countries.
 Refer to www.aid.govt.nz/schols to find out the priority subject areas for your country.
 Visit the institution websites or contact the institutions to find information about their current
qualifications and courses.
 Visit www.studyinnewzealand.com to find information about studying in New Zealand
Auckland University of Technology
(AUT University)
http://www.aut.ac.nz/study-at-aut/internationalstudents
Lincoln University (Christchurch)
www.lincoln.ac.nz/scholarships
Manukau Institute of Technology (Auckland)
(undergraduate study only) (Auckland)
http://www.manukau.ac.nz/students/international
Massey University
(Palmerston North, Wellington, and Auckland)
http://www.massey.ac.nz/massey/international/
University of Auckland
http://www.auckland.ac.nz/uoa/home/for/internationalstudents/
University of Canterbury (Christchurch)
http://www.canterbury.ac.nz/international/
University of Otago (Dunedin)
http://www.otago.ac.nz/international/index.html
Victoria University of Wellington
http://www.victoria.ac.nz/international/
University of Waikato (Hamilton)
www.waikato.ac.nz/international
Unitec (Auckland)
http://www.unitec.ac.nz/futurestudents/international-students/internationalstudents_home.cfm
www.aid.govt.nz/schols
New Zealand Scholarships Application Form | Page 13
JPA(L)LDP 1B/96
[Pin.1/ 2010]
BAHAGIAN PEMBANGUNAN MODAL INSAN
JABATAN PERKHIDMATAN AWAM
PERMOHONAN MENGIKUTI KURSUS DALAM PERKHIDMATAN
ARAHAN:
Gambar
1. Lengkapkan borang dengan jelas, sila rujuk panduan
kod di mana berkaitan.
2. Perlu diisi dalam SATU (1) salinan.
3. Senarai tugas perlu disertakan.
A.
BUTIR-BUTIR DIRI
1. Nama
Penuh
2.
No KPT
3.
No K/P
-
4. Tarikh Lahir
(Hari)
(Bulan)
(Tahun)
5. Umur
6. Negeri Lahir
(rujuk panduan kod)
7. Taraf Perkahwinan
8. Jantina
L - Lelaki
P - Perempuan
9. Keturunan
10. Agama
I - Islam
L - Lain-lain
11. Kecacatan
B.
K - Kahwin B - Bujang
C - Cerai
(rujuk panduan kod)
(rujuk panduan kod)
BUTIR-BUTIR PERKHIDMATAN SEKARANG
12. Klasifikasi
Perkhidmatan
(rujuk panduan kod)
18. Kementerian:
13. Skim
Perkhidmatan:
19. Jabatan :
14. Gred Jawatan:
(rujuk panduan kod)
15. Tanggagaji:
P
20. Jenis Agensi:
T
(rujuk panduan kod)
21. Alamat Tempat Bertugas:
16. Tarikh Lantikan:
(Hari)
(Bulan)
(Tahun)
17. Tarikh Disahkan *
(Hari)
22. Telefon
(Bulan)
(Tahun)
(a) Pej
(b) Rumah
(c) Bimbit
No. Fax:
E-mail:
23. Lantikan pertama ke PERKHIDMATAN KERAJAAN jika lain dari 13
(a) Skim Perkhidmatan:
(b) Tarikh Lantikan:
(Hari)
* Sila nyatakan sebabnya jika belum disahkan
(Bulan)
(Tahun)
:
:
:
C.
BUTIR-BUTIR AKADEMIK
24. Kelayakan:
(a) Sijil
Bidang & Institusi/Universiti
Kelas/CGPA
Tahun
(b) Diploma
(c) Ijazah Pertama
(d) Ph.D/Sarjana/
Dip.Lepasan Ijazah
D.
BUTIR-BUTIR KURSUS YANG DIPOHON
25. Nama Kursus
:
26. Peringkat Kursus
:
27. Nama Institusi
:
28. Tempat/Negara
:
29. Tarikh/Tempoh Kursus
:
30. Penganjur
:
E.
-
/ (
bulan)
KURSUS YANG PERNAH DIIKUTI/BIASISWA YANG PERNAH DITERIMA
31. Kursus yang pernah diikuti dalam tempoh 2 tahun yang lepas
( Sila buat lampiran jika ruang tidak mencukupi )
Nama Kursus
Anjuran
Tempat
Tempoh/Tarikh
32. Biasiswa yang pernah diterima :
Penaja
Tarikh/Tempoh Biasiswa
Kursus Yang Diikuti
Tempoh Kontrak
F.
MAKLUMAT KELUARGA
33.
Nama Suami / Isteri
:
34.
Tarikh Lahir
:
35.
Pekerjaan / Jawatan :
36.
Alamat Tempat Bertugas :
37.
38.
Memohon Hadiah Latihan Persekutuan :
Bilangan Anak
orang
Bil.
39.
:
Ya / Tidak
Sesi :
Nama Anak
Tarikh Lahir
Orang yang boleh dihubungi semasa kecemasan :
(a) Nama
:
(b)
No. Telefon :
(c ) Alamat :
G.
40.
PENGAKUAN PEMOHON ( Potong yang tidak berkaitan )
(a) Saya telah / belum mengisytiharkan harta.
(b) Saya pernah / tidak pernah memohon Hadiah Latihan Persekutuan :
Tarikh Permohonan :
Sesi :
(c ) Disertakan salinan dokumen-dokumen sokongan bertanda ( _/ ) yang telah diakui sah oleh pegawai
kerajaan Kumpulan Pengurusan dan Profesional seperti di bawah :
(i)
Ijazah Pertama atau setaraf
(ii)
Transkrip Ijazah Pertama
(iii) Ijazah Sarjana atau setaraf (sekiranya ada)
(iv) Transkrip Ijazah Sarjana (sekiranya ada)
(v) Keputusan TOEFL/ IELTS/ Bahasa Inggeris (SPM) (sekiranya ada)
(vi) Senarai Tugas
(d) Saya mengaku bahawa semua keterangan di atas adalah benar dan permohonan ini adalah lengkap.
Sekiranya kenyataan yang diberikan tidak benar atau permohonan ini tidak lengkap, JPA berhak
membatalkan permohonan atau Hadiah Latihan ini.
Tarikh:
( Tandatangan Pemohon )
H.
41.
PERAKUAN KETUA JABATAN ( Potong yang tidak berkaitan )
(a) SOKONGAN:
Disokong / Tidak Disokong
(b) TINDAKAN TATATERTIB:
Ada / Tiada
(c) Markah Laporan Nilaian Prestasi Tahunan
(i)
Tahun :
Markah :
(ii)
Tahun :
Markah :
(Iii) Tahun :
(iv) Purata Markah :
Markah :
(d) Pegawai BOLEH / TIDAK BOLEH dilepaskan untuk menjalani pengajian pada sesi yang dipohon.
Saya mengesahkan bahawa semua kenyataan yang diberikan oleh
adalah benar dan permohonan beliau
adalah lengkap.
Tarikh:
(Tandatangan Ketua Jabatan)
Nama:
Jawatan:
Cop Rasmi Jabatan:
I.
UNTUK KEGUNAAN JPA ( BAHAGIAN PEMBANGUNAN MODAL INSAN )
Program LDP
43. Tahun Penajaan
Peringkat Pengajian
44. Bil
46. Negara 1
Negara 2
( jika ada )
Nama Kursus:
Bidang:
Institusi:
Tarikh
Kursus
MULA
51. Tempoh
( Hari )
( Bulan )
( Tahun )
( Bulan )
( Hari )
TAMAT
( Hari )
( Bulan )
( Tahun )
Penganjur
Jenis Cuti Belajar / Hadiah Latihan
Surat Kelulusan
54. Tempoh Kontrak
( jika ada )
( dalam tahun )
PANDUAN KOD
A.
BUTIR-BUTIR DIRI
B.
5.
Negeri Lahir
12. Klasifikasi Perkhidmatan
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
8.
Johor
Kedah
Kelantan
Melaka
Negeri Sembilan
Pahang
Perak
Perlis
Pulau Pinang
Selangor
Terengganu
Wilayah Persekutuan
Sabah
Sarawak
Lain-lain
W.P. Labuan
Keturunan
01
02
03
04
07
08
09
10
13
14
15
16
17
Melayu
Cina
India
Orang Asli Semenanjung
Kadazan/Dusun
Murut
Bajau, Ilanau
Lain-lain Bumiputera Sabah
Melanau
Iban
Bidayuh
Lain-lain Bumiputera Sarawak
Lain-lain
10. Kecacatan
A
B
C
D
E
F
G
H
I
J
Buta
Buta Warna
Mendengar dengan alat bantuan
Pekak
Bisu
Gagap
Cacat Kaki
Cacat Tangan
Lumpuh
Kecacatan Lain
BUTIR-BUTIR PERKHIDMATAN SEKARANG
A
B
C
D
E
F
G
J
K
L
M
N
P
Q
R
S
U
W
X
Y
Z
Pengangkutan
Bakat dan Seni
Sains
Pendidikan
Ekonomi
Sistem Maklumat
Pertanian
Kejuruteraan
Keselamatan dan Pertahanan Awam
Perundangan
Tadbir dan Diplomatik
Pentadbiran dan Pembangunan
Pencegahan
Penyelidikan dan Pembangunan
Mahir/Separuh Mahir/Tidak Mahir
Sosial
Perubatan dan Kesihatan
Kewangan
Penguatkuasaan Maritim
Polis
Tentera
14. Gred Jawatan
Contoh: YY15 =
Y
Y
20. Jenis Agensi
1
2
3
4
5
6
7
Perkhidmatan Awam Persekutuan
Perkhidmatan Awam Negeri
Badan Berkanun Persekutuan
Badan Berkanun Negeri
Penguasa Tempatan
Syarikat Kepentingan Kerajaan
Swasta
1
5
New Zealand Commonwealth Scholarships
2015 Applications for tenure from 2016
Information for Applicants
1. The Application Form
The application form is available from the applicant’s Nominating Agency.
The form can also be downloaded from the page on the NZ Aid web site which
contains information for each country.
A link to the information page for each country can be found here:
https://www.aid.govt.nz/funding-and-contracts/scholarships/eligible-countriesregions
2. Applicant Enquiries
When seeking information or making enquiries concerning eligibility, process, timing
etc. for the New Zealand Commonwealth Scholarships applicants should contact the
Nominating Agency in their country of citizenship.
3. Eligible New Zealand Institutions
A New Zealand Commonwealth Scholarship may be held at a New Zealand
university.
The eight New Zealand universities are listed on page 13 of the application form.
Note that Manukau Institute of Technology and Unitec are not universities so a New
Zealand Commonwealth Scholarship may not be held at either of those institutions
4. Eligible Postgraduate Programmes
Applicants must be applying for direct entry to a Masters or PhD programme at a
New Zealand university.
An offer of place from a New Zealand university must be for a Masters or PhD
programme.
Offers for a pathway programme, for example an offer for a Postgraduate Diploma
leading to a Masters programme, are not eligible.
5. Application to a New Zealand university
Applicants must make an early application to a university.
A Commonwealth Scholarship cannot be confirmed without evidence that an
applicant has received an offer of a place from a New Zealand University.
New Zealand Commonwealth Scholarships - 2015 Applications for tenure from 2016
Information for Applicants
Page 1 of 5
6. Applicant Eligibility Criteria
Intending applicants must ensure that they are eligible to apply for a Commonwealth
Scholarship.
The eligibility criteria are listed on the page on the NZ Aid web site which contains
information for each country.
A link to the information page for each country can be found here:
https://www.aid.govt.nz/funding-and-contracts/scholarships/eligible-countriesregions
7. Application Procedure
Each applicant must submit to their Nominating Agency two copies of their
application - one (1) original and one (1) photocopy. Both the original and the
photocopy must include all requested attachments.
The application declaration in Section 13 on page 12 of the application form must be
signed by the applicant.
In addition to the application form the documents listed on page 2 of the application
form are required.
8. English Language Requirements
The information page for each country on the NZ Aid website has information
regarding the English Language Requirements for admission to a New Zealand
University.
Section 11 of the application form, ‘English Language Competency’ must be
completed by applicants.
9. Nominations from the Nominating Agency
Each Nominating Agency may nominate to Universities NZ a maximum of two
applications from their country.
The specific process to assess the applications that have been received will be
determined and established by the Nominating Agency.
The Nominating Agency will advise applicants whether or not their application has
been nominated to Universities NZ.
10.
The Decision Process - Universities NZ
Universities NZ will receive the nominated applications from the Nominating
Agencies.
New Zealand Commonwealth Scholarships - 2015 Applications for tenure from 2016
Information for Applicants
Page 2 of 5
These applications will be subject to a final check for eligibility and completeness. Any
nominated applications that are found to be ineligible or incomplete will be stored for
a period of six months then destroyed.
Complete and eligible applications will be assessed and reviewed by a selection
committee in Wellington, New Zealand. Members of this committee will be
representatives from the New Zealand Aid Programme at MFAT and representatives
from the Scholarships Committee of Universities NZ.
The selection committee will make scholarship award recommendations to the New
Zealand Aid Programme team at MFAT.
The New Zealand Aid Programme team at MFAT will review the recommendations
and decide which will they will endorse. Only those endorsed by the New Zealand Aid
Programme team may be offered a scholarship.
The New Zealand Aid Programme will liaise with staff at the applicant’s preferred
university to coordinate the details of the offer of scholarship with the offer of place.
11.
Timeline and Due Dates
Each Nominating Agency will set their own country deadline for the receipt of
applications.
Applicants must be aware of this date and abide by it.
Nominating Agencies are aware that their nominations must be received by
Universities NZ in Wellington, New Zealand no later than 31 July 2015.
The selection committee will meet in Wellington in September 2015.
As soon as possible after the committee meeting Universities NZ will write to
Nominating Agencies to advise them of the result for each of their nominees.
Universities NZ will also make direct contact (by email) to advise successful nominees
that they have been recommended to MFAT for a scholarship award.
Universities NZ expects that the Nominating Agencies will advise the unsuccessful
nominees.
The New Zealand Aid Programme team at MFAT will issue the formal offers of
scholarship to the successful nominees.
New Zealand Commonwealth Scholarships - 2015 Applications for tenure from 2016
Information for Applicants
Page 3 of 5
12. Priority Study Areas
Scholarships will be awarded in agreed priority study areas to meet countries’ or
regions’ human resources development needs and training priorities, as set by the
New Zealand Government and Nominating Agencies (as outlined, wherever possible,
in countries’ National Strategic Development Plans and Human Resources Planning
Frameworks).
Information relating to the priority study areas for each country can be found on the
information page for the country on the NZ Aid website.
13. Selection Criteria
The nominations submitted to Universities NZ will be considered by the selection
committee according to the following selection criteria:
- academic merit of the candidate.
- the quality of the research proposal.
- the likely impact of the work on the development of the candidate’s home
country.
The assessment schedule which will be used is:
Academic Merit
· Examination results.
· Academic transcripts.
· Referees’ reports.
· Any academic prizes.
· Other relevant activities.
· Publications, where appropriate.
Development Impact
· The extent to which the candidate illustrates that the proposed study will
increase knowledge about development and / or solutions to poverty
reduction (including, amongst other themes, public health, education,
governance, political, social and economic development and environment).
· Relevance and extent to which the Plan of Study fits well with the strengths
and career aspirations of the candidate.
Quality of Study Plans - PhD Applications
· Extent to which the study programme has been well researched and thought
out, including the identification of appropriate institution and supervisor.
· Degree of innovation.
· Likely impact.
· Clarity of presentation.
· Relevance to field.
· Feasibility.
New Zealand Commonwealth Scholarships - 2015 Applications for tenure from 2016
Information for Applicants
Page 4 of 5
Quality of Study Plans - Master’s Applications
· Extent to which the proposed course / institution of study has been well
researched (including specific options and dissertation topics, where
appropriate) and presented.
· Clarity of presentation.
14. Nominees who are offered a scholarship
If offered a Commonwealth Scholarship, candidates must:
a. reside in their country of citizenship until taking up the scholarship in
New Zealand.
b. be able to satisfy Immigration New Zealand requirements for international
student entry to New Zealand (i.e. medical examination and police
clearance/character checks, etc.).
c. not hold another scholarship during the period of the Commonwealth
Scholarship.
d. agree in writing that they will return to their country of citizenship for a
minimum period of two years following completion of their scholarship in order
to contribute to their country’s social or economic development.
New Zealand Commonwealth Scholarships - 2015 Applications for tenure from 2016
Information for Applicants
Page 5 of 5