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Download AMCHAM Scholarship Application Form -   Foundation@  AMCHAM Scholarship Application Form A. tl '  P ~Y~~1hhv c'hJLnu 6 ~~tlu)

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  • ... ~ ~~

    ~

    . .

    ~~~

    THE AMERICAN CHAMBER OF COMMERCE IN THAILAND

    'Ill e~ m~A'1 e; taJ~nuL'!-u.h:::t'Tl~1 't1 J

    . .-

  • ;;;::: ~~

    ~llfr?~"J

    THE AMERICAN CHAMBER OF COMMERCE IN THAILAND

    Vl1 nT'aA1 eJ b3J~nu 'iutJ~:m A" 1 mJ ~~

    r\MCHA!\1 ;, t, ,: "-''D y th fl oor, GPF Witthayu Tower A, 93/1 Wireless Road, Lumpini, Pathumwan, Bangkok 10330

    Tel : 0-2254-1 041 Ext. 224 Fax: 0-2251 -1605. Email : Foundation@amchamthailand .com

    'ii1 U1UU n11ftnl.~1 (Length of course) 3 years D 4 years D 5 years 0 6 years 0

    0 ~ ., 1 n mfil11 ';l :: ff1 l1~n1"'lf'fn'I.Y1 u (Expected course completion date) .... ..... .... ......... ........ ... ...... ... .. .... ... ..... ......... ... .... .. .. .

    ' 2h:r~mu'~-~>/~\lVl-f l9l ~ m::/i>'I'Ttn1~1

    Faculty I Major Educational Level School Name/ Province Graduation Date

    lllil.JlliU

    (Middle school)

    ~1HJ 1JUR11..1

    (High school)

    ll:;n l~~~D~1~l;~(~lnn)

    (Vocational Degree - if any)

    :!JV\1l'\'11..11~.1 (YI 1 nb~Jb1tJu dd '\'lull.) (University - if any)

    Are you currently receiving any scholarships 0 No I 0 Yes, please provide details

    TirhAJ1i~u 'l'lunT:i~n"J;-1~'~-~> 'J '

    e:J\l~m I i>'ftnD'l-1./ 'lJA~~ ~i>'fitlJi>'I'U\.t.nT'iL~nu ' ' '

    From I To Organization/Institution/ Other sponsor (Please give details)

    Have you ever received any scholarships 0 No I 0 Yes, please provide details

    TI~bAll1~~'lJ'Yl'l-l>n1'l~n"J;-1~'~-~> ') a-:~~m I ?lmu"''l-1. I lJAA~ ~~it'lJi>'f'I-I>Un1~L~rm ' ' . '

    From I To Organization/Institution/ Other sponsor (Please give details)

    ,

    (GPA.X)

    .>'1'1-1>1'1-lo/il

    Amount I year

    .>'11-1>1'\tlil

    Amount I year

    41

  • ~- ~ ~ :~::~~:,:~~:~"~:~~:~:"R OF COMMERCE IN THAILAND ,,,,.,,.,,,.,,=- 71h floor, GPF Witthayu Tower A, 93/1 Wireless Road, Lumpini, Pathumwan, Bangkok 10330

    AMCHAM IH.\ILi;'''D Tel: 0-2254-1041 Ext. 224 Fax: 0 -2251-1605. Email: Foundation@amchamthailand.com

    (Activities I Community Service)

    Name of Organization When Describe Your Role Highlight the results of your activities

    'ffmumrn'l'lJ'H1''1Jt:l~lim11l'i'Yll (Parent' s Marital Status)

    D mj~:anl'l-h (Live together) ..

    0 U~'1-3J'1~l91'1 (Parents) 0 ~tlnl'l~e:J\l (Guardian)

    ~e:JUl91'1 Father Name

    rrunl'l1B\l (or) Guardian Name 'U .

    0 'IHh~l\l (Divorced) 0 bLVnll~ta.i (Separated) ..

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    e:ll.1 '

    Alive Deceased Age

    b1JB1'trr~~lilt'iB

    Phone No.

    51 . '

  • THE AMERICAN CHAMBER OF COMMERCE IN THAILAND

    vmm"H'l1e:Jl:IJ~n~L~tl~~l"Yl~1n!!.~

    A MCHAM : :\:.. ..

  • ~ ~

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    THE AMERICAN CHAMBER OF COMMERCE IN THAILAND

    'liifl n1~~1flL3J~n~ b~U'i~L'I'1~1 '1'1~

    . ~~

    AMCHAM : : .. \il> . 'r:.> 7

    1h floor, GPF Witthayu Tower A, 93/1 Wireless Road, Lumpini, Pathumwan, Bangkok 10330

    Tel: 0-2254-1041 Ext. 224 Fax: 0 -2251-1605. Email : Foundation@amchamthailand .com

    .d e:n~~ ~ d 0 ~HI 11~ 61'tl1% n~1/61'm~'l'l'l'11\l1~

    Name Age Occupation School/University/Work place

    (Photo of family home. Show full house)

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  • THE AMERICAN CHAMBER OF COMMERCE IN THAILAND

    Vl 1n1aA1eJ tll~n'~-~>lm.h~ml'f1raJ

    AMCHAM ;;;"'.: '' f: 7th fl oor, GPF Witthayu Tower A, 93/1 Wireless Road, Lumpin i, Pathumwan, Bangkok 10330

    Tel: 0-2254-1041 Ext 224 Fax: 0-2251-1605. Email: Foundation@amchamthailand .com

    q (Income & Expenses)

    ... t\Pl 1'11>6it 1J1Yl \J1n (From)

    (Monthly Allowance) ~ae:1 u ~ f1/~tl n ~ aEl\1 '-' IV amn\1 "'

    mJIPf. Vl~fl eriiatlmat~ m ... . . .

    Family or Guardian Employment Student Loan ~'~-~> 'J {a::u)

    bDai.Pl4~1JI'hb~~1~b'l-utrPi6i~ t~f!U (Please Provide Details of Monthly Expenses)

    (Rent & Utilities I

    Month)

    l'i1 '1haJ"Hi~h

    L(;) m'11"i

    (Transportati

    (Food/month)

    (Other

    Personal

    Phone & Expenses/Me

    on I Month) internet I month nth)

    E. t~hllf>L~Ill\IA'l13J'nil'i"tJ'11-fl (Personal Statement)

    In your own words , provide a 1-page personal statement on :

    a) Why y9u wi sh to apply for this scholarship?

    ~11~n"~~~1~ B11l~~?

    Other (specify)

    l'i1LGl'1L~tJ~/I'i1

    uT~\l/ '

    (Tuition &

    other fees I

    semester)

    l'iT11"11~el LL ~::

    utlmn! '

    (Books &

    supplies I

    semester)

    b) What academic and personal achievements make you a suitable candidate to receive this scholarship?

    w:n~ i.t1l11il l1h!.1"111n1"iVi~tJ~1~c;\1hnh-J~~11~un L1tJ~~c;rh.~:ufl11';)::1c;lfuml.? c) How do you think you will benefit in terms of career and personal development from obtaining this

    Scholarship?

    ~m.h::: 1t~"lfuc;i'1~m1i4"

  • = THE AMERICAN CHAMBER OF COMMERCE IN THAILAND ~ ~

    .. ~

    AMCHAM !;;,\ :u, ,::, 71h floor, GPF Witthayu Tower A, 93/1 Wireless Road, Lumpini, Pathumwan, Bangkok 10330

    Tel: 0-2254-1041 Ext. 224 Fax: 0 -2251-1605. Email: Foundation@amchamthailand.com

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  • THE AMERICAN CHAMBER OF COMMERCE IN THAILAND

    71h floor, GPF Witthayu Tower A, 93/1 Wireless Road, Lumpini, Pathumwan, Bangkok 10330

    Tel: 0-2254-1041 Ext. 224 Fax: 0 -2251-1605. Email: Foundation@amchamthai land.com

    .... "' "' l'U'Yl ............. b~ El'i-b ... .. .. .. ......................... l'l.fl .... .. . ......... .

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    ...... ... ........................... .. .......... ..... .. ..... ...... ...... .. ...... ... ........ ....... ... ..... ............ .... ....... ................... ......................

    .. Name (lil.,J'liEJ) .............................. ...... ....................... .

    ( ............................. .... .... ........ .................. )

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  • .::= 'Vle:Jm-s~1e:naJ~n"~-~>tutl-a:::mY~lnEJ ~~.-~.; __ .=:-~ __ .~=_ , THE AMERICAN CHAMBER OF COMMERCE IN THAILAND 7 th floor, GPF Witthayu Tower A, 93/1 Wireless Road , Lumpini, Pathumwan, Bangkok 10330 AMCHAM fi !. r :Mm Tel: 0-2254-1041 Ext. 224 Fax: 0 -2251-1605. Email: Foundation@amchamthailand.com

    iuri ............. L~El'U. .................................. 'Y-I.f'! ................ .

    i1Y-IL"ii'1 / ........................................................................................................................................................ . ~ t>'.d,. ,~

    EJ1";JTHJ/EJ1';J1"H.Ji1lJ"JnB1"l.IEl-J'U.1 Ll I 'U.1.JW11 .. ................ ...... .... ...... ................... . " ' AA Q..

  • --E:.;_; :~:~;:,:~~:~~~:~n:~:"R OF COMMERCE IN THAILAND ~L~ 7111 floor, GPF Witthayu Tower A, 93/1 Wireless Road, Lumpini, Pathumwan, Bangkok 10330 AMCHA M '1 L\ ~t .. m Tel: 0-2254-1041 Ext. 224 Fax: 0 -2251-1605.

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