1059b151500687 (1).pdf
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2215 - Graduate Scholarship Programme for International Students Application Form
PROGRAMME CODE APPLICATION PERIOD DEADLINE APPLICATION NUMBER2215 2015 / 1 03/04/2015 17:00 1059B151500687
Personal InformationCountry of Citizenship : INDONESIA
Passport Number A5103232
Name Last Name BADRUL HUDA HUSAIN
Sex Male
Date of Birth 01/09/1993
Birth Place MALANG
Father?s Name KASIONO
Title OtherCommunication Info
Country ENDONEZYA City MalangTown Zip Code 65146Phone +62-81265863077 FaxCell phone +62-81265863077 Cell phone2 +62-81265863077E-mail [email protected] JALAN BANDULAN XIV NO : 249,RT:05,RW:01,KEC.SUKUN JALAN BANDULAN XIV NO :
249,RT:05,RW:01,KEC.SUKUN
Application InfoI apply for: MSc-MA scholarshipField of Study Technical Sciences > Marine Sciences And TechnologyLevel of Education I am holding a Bachelor's degree or am currently enrolled in the last year of an undergraduate program from
out of TURKEY
Undergraduate InfoUniversity Brawijaya UniversityDepartment Marine Science(*Expected or Actual)Undergraduate graduation date
08/06/2015
University grade system 4 Undergraduate GPA 3.52
Master InfoUniversityDepartment/Major(*Expected or Actual) Master`sGraduation DateUniversity grade system 0 Master`s GPA 0.0
Doctorate InfoUniversity/FacultyDepartment/MajorDoktorate Registration DateUniversity grade system 0 0.0
Curriculum Vitae and PublicationsUpload CV CURRICULUM_VITAE.jpg
Foreign LanguagesLanguage Level of languageENGLISH Good
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RefereesName Last Name Bambang Semedi Title Doktora SonrasE-Mail [email protected] Phone +6285733691900Institution Brawijaya University - Faculty of
Fisheries - Marine ScienceDepartment
Name Last Name Nurin Hidayati Title Yksek Lisans MezunuE-Mail [email protected] Phone +6285755778265Institution Brawijaya University - Faculty of
Fisheries - Marine ScienceDepartment
Name Last Name Aida Sartimbul Title Doktora SonrasE-Mail [email protected] Phone +6281553271689Institution Brawijaya University - Faculty of
Fisheries - Marine ScienceDepartment
Additional Financial Support Info
Additional DocumentsReference/Recommendation Letter LETTER_OF_RECOMENDATION_TUBITAK_(Ir._Aida_Sartimbul,_M.Sc.,Ph.D).jpg,
LETTER_OF_RECOMENDATION_TUBITAK_(Ir._Bambang_Semedi,_M.Sc.,Ph.D).jpg,LETTER_OF_RECOMENDATION_TUBITAK_(Nurin_Hidayati,_ST,_M.Sc).jpg
Copy of Personal Information Pageof Passport
PASPORT.jpg
Statement of Purpose STATEMENT_OF_PURPOSE_(FIRST_PAGE).jpg, STATEMENT_OF_PURPOSE_2_(SECOND_PAGE).jpgLanguage Certificate SCORE_REPORT_INTERNATIONAL_TOEIC_(ETS).jpg,
SCORE_REPORT_INTERNATIONAL_TOEFL_(ETS).jpg,CERTIFICATE_INTERNATIONAL_TOEFL_(ETS).jpg
Undergraduate Transcript ACADEMIC_TRANSCRIPT_(TRANSLATED).jpgOther Documents ASSISTANT_OF_APPLIED_COMPUTER_IN_MARINE_SCIENCE_(TRANSLATED).jpg,
ASSISTANT_OF_MARINE_ECOLOGY_LECTURER_(TRANSLATED).jpg,SCHOLARSHIP_CERTIFICATE_for_GIFTED_STUDENT_(TRANSLATED).jpg,CERTIFICATE_OF_STUDENT_STATUS_(TRANSLATED).jpg,MODERATOR_OF_SEMINAR_(TRANSLATED).jpg, FISHERIES_SEMINAR_(TRANSLATED).jpg
Certificate of Achievement in theInternational Science Olympiads
Chemistry_International_Olympiads.jpg, Science_International_Olympiads.jpg
You must keep all the documents that you uploaded to system and the Application Form to TUBITAK given by the system after the approvement ofthe application. Applications not fulfilling cited conditions, lacking any of the required documents will not be processed.
I confirm that the information given on this application form is true, complete and no information requested was omitted.
First Nameand LastName:
BADRUL HUDA HUSAIN
Date : 01/04/2015Signature :