Undergraduate Application Form Aid to Maldives Scheme ICCR

c
Department of Higher Education
Ministry of Education
Male’, Republic of Maldives
Scholarship Application Form ICCR Scholarships 2015/2016
You should submit the following items with this application form in sealed envelope.
1.
2.
Attested originals of all qualifications stated in paragraph 3 (you may attest your copies of qualifications from a government office)
A release letter from the employer if you have a bond to serve
(WRITE CLEARLY IN BLOCK LETTERS)
1. Personal
Name
Permanent Address
(including Atoll/Island)
Current Address
M
F
Sex
(recent PP photo)
Mobile
number
Age
Date of Birth (D/M/Y)
years
E-mail Address:
Govt. Record Card No.
Marital Status
ID No.
 SINGLE
 MARRIED  DIVORCED
Number of
Children
Their
ages
2. Employment
Date Empl.
Post
Office
Tel
Present
Employment
First Empl.
in Gov’t
3. Educational Qualification
GCE O/Level & SSC
Subject
Grade
Year
GCE A/Level & HSC
1. DHIVEHI
Subject
8.
Grade
Year
2. ISLAM
9.
3. ENGLISH
10.
2. ISLAM
3.
4. MATH
5.
6.
7.
11.
4.
Grade
Year
1. DHIVEHI
12.
13.
14.
Attainment (Certificates received)
Institute / Country
Subject
5.
6.
7.
From
To
SSC & GCE O/LEVEL (GR. 10)
Funding Scheme
---
Course / training currently being undertaken
Institute
Programme
Level
Duration
Date started/End
Funding Scheme
4. Desired Course
Course name
Advertisement / Notice ref.
& date
(IUL)166-schol/166/2015/8 (25 January 2015)
Scholarship Application Form – DHE
Level
Bachelor’s Degree
Country of
Study
India
Scheme
ICCR/Aid to Maldives Scheme
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5. Employment History
Post & Office
6. Service Bond Records
Nature of Bond
(studies / training course / paid leave)
Please indicate the name of the organization
through which you were trained and the
duration of the course
From
Bond
Duration
To
Date Began
Service
Field of work
Date of Bond
Completion
Status
(completed / deferred / serving)
7. Student Loan Status
Do you have an outstanding student loan in the Bank of Maldives or at Department of Higher Education?
If Yes, Please submit evidence that repayment is regularly made. Copies of the Bank letters, repayment slips can be
submitted as evidence
8. Other Applications to Scholarships in 2011,2012,2013,2014
Course (including level)
Office
Country
Funding
Scheme
Date
Applied
Yes
No
Status: (selected**
pending / rejected)
* * A p p l i c a n t w i l l b e d i s q u a l i f i e d i f i n f o r ma t i o n i s wi t h h e l d .
9. Parent / Guardian / Spouse
Name & Address of  Responsible Parent
OR
 Guardian
OR
 Spouse
Tel
10. Applicant’s Declaration
I ................................................ certify that to the best of my knowledge, all information provided in this application is accurate and complete. I
understand that false, misleading, incomplete or omitted information could lead to the invalidation of my application. If my application is accepted, I
undertake to abide by the regulations of the Government. Furthermore, rejection of the course after selection (without any valid reason) could black
list me with the condition that I may not get any chance to receive a government scholarship for a certain period by the Department of Higher
Education.
Signature of the Applicant:
Date:
Please submit the completed form, with supporting documents, in a sealed envelope addressed to:
Department of Higher Education
Ministry of Education
Velaanaage (2rnd Floor
Deadline for submission: 72th January 2015 (10:00am)
Our Telephone number is: 3341380

Please double check if your application is complete. Are the following documents included?
Attested originals of all qualifications stated in paragraph 3…………………………..…
A release letter from the employer if you have a bond to serve …………………………
Yes
Yes
No
No
Have you ever studied in India
Yes
No
Are you currently studying in India
Yes
No
Have you ever studied under ICCR scholarship
Yes
Please fill the following information
No
NOTE 1: You should enclose the application and other documents in a sealed envelope with your Name, Address and Applied
Course and Scheme clearly written on the envelope.
NOTE 2: Please ensure you obtain a receipt on handover of the documents and note the reference number on the receipt.
Scholarship Application Form – DHE
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