APPLICATION FOR UNDERGRADUATE SCHOLARSHIP


IMPORTANT:

Please read the instructions carefully prior to filling the form. Due to the large number of applications received, candidates will be short-listed according to information furnished in this form. Any incorrect information furnished by the applicant will result in disqualification of the applicant from the scholarship program.

  • Only full-time 3rd year students who are citizens of Sri Lanka are eligible to apply for scholarships under this programme.
  • The details of education and the present performance at the university will be verified with the Dean of the faculty. In the event of false information being discovered after the scholarship has been awarded, MIND reserves the right to cancel the same.
  • Applicants need to produce original certificates (educational, sports, etc.) if they are called for an interview.
  • Applications that are incomplete and not received on the closing date will be rejected.


(Application closing date: Friday, 16th June 2017)



1 . PERSONAL INFORMATION


Full Name
Permanent Address
                    
Contact Numbers
                    
Email
                    


2 . FINANCIAL STATUS


Original copies of relevant documents must be brought to the interview.

1. Details of family income (Please include all members of the family living with you, including self)

Relationship to applicant Occupation Place of work (if applicable) Annual Income (If applicable)
1
2
3
4
5

2. If you are now receiving a scholarship or any other funds from the government/other institution, state the amount and other details.

3. State all other income derived from estates, land, houses, shares etc by the family
Source Amount (Rs)
1
2
3
4
5

3 . EDUCATION AND ACADEMIC PERFORMANCE


State the university and faculty of education
Year of GCE (A/L) examination from which you qualified to enter University
University entrance batch no
Field of study
Present level (year) at the faculty
Average results in the past years at the university (documentary proof must be brought to the interview)
Year1 :
Year2 :
Grade obtained at the GCE O/L and A/L examination
O/L English language :
A/L English language :

4 . PROFESSIONAL QUALIFICATIONS/EXPERIENCE


Study courses followed (eg. CIMA or part exam, Diplomas, English courses, etc. work experience, etc.)

5 . EXTRA CURRICULAR ACTIVITIES


State in brief the activities eg. school prefect, member debating team, cricket team or any other field of sport, music drama, religious activities etc. in school, University or in private capacity.