Name Faculty AJniversitl,

Semester/Student lD

GOODWILL LEA,DF"R,SI-IIT} HEVELOPMENT SCHOL.ARSIP PROGRAM

Application 2014'2015
please, answer every question with capital letters and attach all the information related to the questions

1.

Personal Data
birtl

Date and place of

Mmital stahr.s (single/rnanied)

Present addres s/telcph cxie

Home address/lelephone School address/telephcrne

Emergencl' contact
Person/address/telephone.

Type of accomrnodation (pmen8/relatives/dorm/ rented room/other - please state)

Hobbies/interests

2.

Family lnformation
Father
Name:

Mother

Address:
Job: Gross salary (olease attach evidence'!

Level ofeducation

Brothers/sisters How many?

What age?

Brothers

Sisters

Additional comments

Name Faculty AJniversity

Semester/Student ltr)

3.

Financial Data

How much is your annual tuition fee?

Please list what you actually paid in 2013-14

How much is your actual monthly expenscs?

Please specify.

Housing
Food

Transport School books/stationary

Other

Total

Please list all sources of income you received per month from January to November 2013, from where and how

Parents

Other family members

Scholarship Job

rnuch?

Other

Total

How did )'ou coyer your school fees and other monthly
expenses?

Present paid job and position? How many hours do you work every month? How much do you earn every month? How long have you had this job?

4.

Scholarship

llave you ever received any scholarship award in the past two years? If you have, please list from where, how much, how long.

Name Faculty ,{Jniversitl,

5.

Semester/Student

ID

Academic lnformation
Elementary school
Comments

Middle School
Comments

High School
Comments

University attending
Faculty

Depafiment

Year of entrance

Year of study/semester in August 2014 - January 2015

Year/month to complete study

Grade point Average (GPA or IPK) for past 3 semesters (please attach official transcripts) Have you received any awards

from your university If yes, please explain.

List completed certified courses,
and how long you took each course.

(English, computer course, etc)

List your academic and

non academic achievements

Name Faculty AJniversity

Semester/Student

ID

6.

ltlon -academ ic experiences

4.1 Please list 1'our organizational experiences and positior/s you have held during the past
three years.

4.2 Please list your ex*acurricular and volunteer activities during the past three years.

4.3 Please list your paid job experiences and positions you have held during the past three yearc.

4.4 To which activity or interest have you made the greatest commitrneni or contribution? Why? What do you feel you have accomplished?

Name Faculty AJniversity

Semester/Student

lD

8.

Additional Questions

Help us to get to know you better. Be yourself. There is no right or wrong answers. Please type your answers on a separate sheet in English and attach to the application form. Write your name and school as well as the date in the corner of each page.

2.

1. Tell us the field of study that interests you. 'Why? How did your interest develop?
How are you going to apply the knowledge from your courses in your work after universify to
benefit the country? Choose three adjectives to describe yourself. Comment briefly on your choice Why do you think you are the right person to receive the Goodwill Leadership Development Scholarship Award?

3. 4.

scholarship award, are you willing to participate in Goodwill activities, including our training programs and'meet the sponsor' gathering? If you answer is "yes'', how are you going to arrange your time as you may have classes and other activities? .6. If you would like the Goodwill Committee to know any special circumstances not reflected in your application, please describe.

5. If you receive a Goodwill

9.

Profile

In order to attract prospective sponsors to support your education, we have to write your profile. Please help us to write a concise profile for the purpose of convincing the perspective sponsors to support your education. Include your background, achievement, experiences and activities, and why it should be attractive to the prospective sponsors. Please, note that writing your own profile is like writing a short essay about yourself. We don't want your CV.

10.

Essays

Your essays are a very important part of your application. We want to get to know you. We also want to see how well you present yourself.

For each question below, please type a one page essay with approximately 300-400 words in English. Make sure to put your name and your school as well as the date in the corner of each page. Attach the essays to your application form. Note: One essay answering three questions is

g!
1.

acceptable. Name a non-religious figure, person (other than your family), place, book or event that has affected you and caused you to change your outlook on life. Describe an experience that has given you a sense of satisfaction or pride. Explain why you were satisfied or proud.
Describe a situation or activity in which you took a leadership role. What qualities do you Possess that distinguish you as a leader?

2. 3.