WAAW Foundation 2011 Scholarship Application

Thanks for your interest in the WAAW foundation 2011 Scholarship. Please fill out the form as completely as possible. If we think your qualifications match, we will contact you.

1.) Contact Information

First Name: ____________________________________________

Last Name: ____________________________________________

Title: ____________________________________________

Organization: ____________________________________________

Street Address: ____________________________________________

Apt/Suite/Office: ____________________________________________

City: ____________________________________________

State: ____________________________________________

Postal Code: ____________________________________________

Country: ____________________________________________

Email Address: ____________________________________________

Fax Number: ____________________________________________

Phone Number: ____________________________________________

Mobile Phone: ____________________________________________

2.) Date of Birth (DD/MM/YEAR)

____________________________________________

3.) Gender/Sex

( ) Male

( ) Female

4.) How would you describe yourself?

	Excellent	Average	Poor
Intellectual Capability	( )	( )	( )
Detail oriented	( )	( )	( )
Communication (Oral and written skills)	( )	( )	( )
Diligent and Hardworking	( )	( )	( )
Leadership Skills	( )	( )	( )
Interest in Graduate Study e.g.Ms/PhD	( )	( )	( )
Interest in Non profit work	( )	( )	( )

 

5.) List any employment, professional or non-profit organizations, volunteer activities, extracurricular activities you have been involved in over the last 5 years, including dates and in what capacity.

Educational Information

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6.) What is the highest level of education you have completed?

( ) High School

( ) Some College Work

( ) Associate's Degree

( ) Bachelor's Degree

( ) Some Graduate Work

( ) Graduate Degree

( ) Trade or Vocational School

 

7.) List awards or Scholarships/Fellowships you have received with dates.

 

8.) Enter your educational information in chronological order.

	Educational Institution	From (Date)	To (Date)	Certificate Obtained

 

 

Essays

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9.) In 500 words or less, please write an essay on your future career goals and how you expect the WAAW foundation scholarship will assist in fulfilling those goals.

 

10.) In 300 words or less, please describe what you believe about female education in Africa and its impact on research, development or advancement in African economies.

 

11.) Describe in ten or less sentences how you intend to use the funds from WAAW scholarship to assist your education and career plans.

References

Please provide information on two academic or professional references below: If you are shortlisted, WAAW will contact your references directly.

Reference 1:
Name:    _______________________________________________
Title:      _______________________________________________
Address _______________________________________________
Phone Number: ________________________________________
Email:    _______________________________________________
How long has this person known you? ______________________

Reference 2:
Name:    _______________________________________________
Title:      _______________________________________________
Address _______________________________________________
Phone Number: ________________________________________
Email:    _______________________________________________
How long has this person known you? ______________________

How did you hear about WAAW Foundation?

____________________________________________

 

Please read and sign the statement of truth (check the box below):

STATEMENT OF TRUTH:
 I certify that the information I have provided on this application form and all other application materials are complete, accurate, and true to the best of my knowledge. I understand that furnishing false or incomplete information on any part of this application may result in cancellation of the scholarship award or repayment of full or partial scholarship funds. I give permission to WAAW to take necessary measure in verifying the information provided on this form. The information provided here becomes the property of WAAW. I release WAAW and its officials from all liability resulting from information provided for this application.

________________________________
Signature

Thank You For Your Application
Thank you for submitting your application for the 2011 WAAW Foundation Scholarship. We will contact you with a decision on your application in Nov, 2011. If you are shortlisted, you will be required to furnish a recent transcript from your current school and we will follow up with your referees directly.

Thank you again!

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