humanitarian scholarship application form 2012-13 (1)

8/13/2019 Humanitarian Scholarship Application Form 2012-13 (1)

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APPLICATION FOR GOLDSMITHSHUMANITARIAN SCHOLARSHIP 2012/2013

Four Goldsmit s Hum!"it!ri!" S# ol!rs i$s !r% !&!il!'l% to stud%"ts stud(i")*or ! t!u) t M!st%rs d%)r%% !t Goldsmit s+ , o #om% *rom #ou"tri%s !**%#t%d '(

,id%s$r%!d o$$r%ssio"+ $%rs%#utio"+ $oliti#!l or milit!r( stri*% su# t !t t %ir

um!" ri) t to $ost)r!du!t% %du#!tio" is d%"i%d to t %m-T % s# ol!rs i$ $ro&id%s *ull tuitio" *%%s+ m!i"t%"!"#% !"d !ir*!r%s to !"d *romt % U.- Pl%!s% !$$l( !s soo" !s $ossi'l%+ *i"!l d%!dli"% 1 A$ril 2012-

INSTRUCTIONS Ensure your application and supporting documents are TYPED if possible. If you are unable

to type the form, please make sure you write legibly (print in black ink . You must include an E!"I# "DD$E%% on the form (as this is our main method of contact Your reference must be signed, dated and printed on letter&headed paper. Pro'ide )PIE% of transcripts and certificates, not originals. Please supply them again e'en

if you ha'e included them with your course application. You must ha'e already submitted an application for a place on your chosen course. If you would like this form to be sent to you in an alternati'e format, please contact us.

S CTION A P RSONAL D TAILSSur"!m%/F!mil( N!m%

First N!m%

Titl% (e.g. !r*!s +

D!t% o* irt (dd*mm*yyyy Cou"tr( o* Ori)i"

CONTACTm!il Addr%ss

CORR SPOND NC ADDR SSStr%%t Addr%ss Cit( !"d R%)io"/Cou"t(//St!t%

Post#od% Cou"tr(

INT ND D PROGRAMM OF STUD AT GOLDSMITHS4u!li*i#!tio" Sou) t (e.g. !"

Pro)r!mm%/Cours% Titl%

Goldsmit s D%$!rtm%"t T($% o* o**%r %ld (if you hold one e.g.unconditional or conditional

Pro)r!mm% St!rt D!t% A$$li#!tio" r%*%r%"#% "um'%r( &digits, at the top of your offer letter, if you ha'eone +

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S CTION LIGI ILITPl%!s% %5$l!i" , ( !"d o, (our !##%ss to $ost)r!du!t% %du#!tio" is r%stri#t%d '(t % #urr%"t situ!tio" i" (our #ou"tr(- Dr!, !tt%"tio" "ot o"l( to *!#tors , i#!$$l( )%"%r!ll( to )r!du!t%s i" (our #ou"tr( 'ut !lso to !"( *!#tors , i# !r% o*$!rti#ul!r r%l%&!"#% i" (our $%rso"!l #!s% (box will expand as you type 500words max*)

6 If you prefer, you may write your statement on a separate piece of paper and attach it to thisform.

S CTION C ACAD MIC AND 7OR. HISTOR

DUCATION FROM TH AG OF 18%tart with current or most recent, and include professional -ualifications where appropriateI"stitutio" N!m%9 Lo#!tio" (city andcountry

St!rtd!t%(mm*yyyy

"dD!t%(mm*yyyy

4u!li*i#!tio"!# i%&%d(e.g. " #e'els,I , "bitur, ",

%c, !"/..

Su':%#t O&%r!llGr!d%+GPA orCl!ss

Possi'l% )r!d%r!")%(highest 0 loweste.g. 1&2, "&3, 1445 & 45

MPLO M NT+ TRAINING AND 7OR. ;P RI NC 6here rele'ant to the programme or scholarship re-uirements

m$lo(%r "!m% !"d lo#!tio"(city and country

St!rt D!t%(mm*yyyy

"d D!t%(mm*yyyy

Positio" %ldL!")u!)

% !t ,or<

PRI= S+ A7ARDS AND SCHOLARSHIPS A7ARD D FOR PR >IOUSSTUD /R S ARCH 6e may re-uest proof of the information you gi'e below.

N!m% o* Pri?%+ A,!rd orS# ol!rs i$

Pur$os% 6hat was the pri7e, award orscholarship awarded for8

O&%r!ll &!lu% G @if applicable

D!t% !,!rd%dmm/((((B or

Dur!tio"as applicable

S CTION D P RSONAL STAT M NT

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Pl%!s% %5$l!i" , ( (ou !&% # os%" to !$$l( *or t % $ro)r!mm% id%"ti*i%d i"S%#tio" A !'o&%+ !"d o, (ou %"&is!)% t is u!li*i#!tio" !"d (our %5$%ri%"#% o*stud(i") i" t % U. #o"tri'uti") to (our *utur% #!r%%r $l!"s (box will expand asyou type 250 words max*)

I" , !t ,!(s ,ould (ou o$% to $!rti#i$!t% i" !"d #o"tri'ut% to t % !#!d%mi# 9so#i!l dim%"sio"s o* li*% !t Goldsmit s (box will expand as you type 150 words

max*)

6 If you prefer, you may write your statements on a separate piece of paper and attach it to thisform.

S CTION SUPPORTING DOCUM NTS

ou MUST !tt!# t % do#um%"ts list%d '%lo,- 7it out t %m (our !$$li#!tio" ,ill '% d%%m%d i"&!lid- Pl%!s% do "ot !tt!# !dditio"!l do#um%"ts su# !s C>s !s t %( ,ill '% disr%)!rd%d *rom (our !$$li#!tio"- I* (ou !r% u"!'l% to o't!i" #%rt!i"do#um%"ts+ $l%!s% $ro&id% !" %5$l!"!tio" o" ! s%$!r!t% $i%#% o* $!$%r-

Pl%!s% i"di#!t% i" t % ri) tE !"d #olum" , i# do#um%"ts (ou !&%%"#los%d- 5

Photocopies of official college and uni'ersity degree certificates and transcripts.

"cademic $eference relating to your current or most recently completed course (e.g.from personal tutor , or a professional reference if appropriate. You may submit a copyof your programme application reference if you wish.

Co"*irm!tio" t !t (ou !r% %li)i'l% 5I confirm that I ha'e submitted a separate application for admission on my course+I confirm that I am liable to pay the International rate of tuition fees+

S CTION F APPLICANT S D CLARATION

Please read the following statements and sign below to indicate acceptance ofthese terms

I declare that the information I have provided on this form is correct to the best of myknowledge I consent to my data being processed and shared with college staff for the purposes ofselection, assessment, payment, reporting and monitoring I understand that if, subsequent to submitting my application, information I havesupplied in support of my application is found to be incorrect, Goldsmiths Collegereserves the right to reject the application I understand that, if awarded a scholarship, I will need to provide a student profile foruse in marketing and recruitment materials and make myself available to assist in therecruitment activities of the College I understand that the personal data which I have provided on this form may be stored in

paper and/or electronic form in accordance with Goldsmiths College policies on Data rotection !available at" http"//www#gold#ac#uk/data$protection/% and with the provisions of the Data rotection &ct !'(()%

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Name: Date:

%ignature+

MAIL APPLICATIONSI* (ou !r% %m!ili") (our !$$li#!tio" to us ,it s#!""%d !tt!# m%"tsB $l%!s% ti#

humanitarian scholarship application form 2012-13 (1)

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