Applications will only be processed upon receipt of all of the following documentation: 1. Completed Application Form. 2
Scholarship Program 2018 Application Form
Please complete all parts of the form and submit to Admissios Office with supporting documents on or before November 30th, 2017.
APPLICANT Full name
: ______________________________________________________________________________________
Gender
: ______________________________________________________________________________________
Date of Birth :
/
/
(date/month/year) Place of Birth : _____________________________________
Nationality
: ______________________________________________________________________________________
Address
: ______________________________________________________________________________________
______________________________________________________________________________________
CURRENT SCHOOL School Name : ______________________________________________________________________________________ Current Year : ______________________________________________________________________________________ Address
: ______________________________________________________________________________________
__________________________________ E-mail : __________________________________________
GIFTED & TALENTED Have you been part of a Gifted & Talented Programme or have any specific talents or abilities? Please list them here. ____________________________________________________________________________________________________ ____________________________________________________________________________________________________ ____________________________________________________________________________________________________
PARENTS Father
Mother
Full name : ________________________________ Nationality : ________________________________
Full name : ________________________________ Nationality : ________________________________
1st Language : ________________________________
Occupation : ________________________________
Occupation : ________________________________ Phone
: ________________________________
Work Address : ________________________________ E-mail
: ________________________________
Phone
: ________________________________
E-mail
: ________________________________
Scholarship Program 2018 Application Form
PARENT CONSENT I/We approve my child applying for a scholarship at AIS Indonesia for the 2018 School Year. Parent’s signatures
______________________________ Father
______________________________ Mother
Date : ___ / ___ / ___
ADDITIONAL INFORMATION Please Note: Applications will only be processed upon receipt of all of the following documentation: 1. Completed Application Form 2. Copy of student Passport or proof of Nationality 3. Two passport size photos of student 4. School reports for the last 2 years 5. 500 word essay in English Processing of Application: all the above documents should be submitted to Admissions Office. By email to:
[email protected] or By post to: Admissions Office AIS Indonesia, Kemang Campus Jl Kemang Timur No. 81 Kemang, Jakarta Selatan 12730
You will be contacted within one week of receipt of application. Applicants will be invited to sit an online test in Mathematics and English on December 9th, 2017. From this test applicants who are selected to proceed further will be invited to an interview with the Scholarship Committee. Scholarship winners to be announced on December 15th, 2017.