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2215 - Graduate Scholarship Programme for International Students Application Form PROGRAMME CODE APPLICATION PERIOD DEADLINE APPLICATION NUMBER 2215 2015 / 1 03/04/2015 17:00 1059B151500687 Personal Information Country 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 Other Communication Info Country ENDONEZYA City Malang Town Zip Code 65146 Phone +62-81265863077 Fax Cell phone +62-81265863077 Cell phone2 +62-81265863077 E-mail [email protected] Address JALAN BANDULAN XIV NO : 249,RT:05,RW:01,KEC.SUKUN JALAN BANDULAN XIV NO : 249,RT:05,RW:01,KEC.SUKUN Application Info I apply for: MSc-MA scholarship Field of Study Technical Sciences > Marine Sciences And Technology Level 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 Info University Brawijaya University Department Marine Science (*Expected or Actual) Undergraduate graduation date 08/06/2015 University grade system 4 Undergraduate GPA 3.52 Master Info University Department/Major (*Expected or Actual) Master`s Graduation Date University grade system 0 Master`s GPA 0.0 Doctorate Info University/Faculty Department/Major Doktorate Registration Date University grade system 0 0.0 Curriculum Vitae and Publications Upload CV CURRICULUM_VITAE.jpg Foreign Languages Language Level of language ENGLISH Good

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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

  • 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 :