Scholarship / Award Application Form
For the applicant’s attention:
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Please carefully read the statute and guidelines.
The form must be typed out.
Clauses 1-7 and 9 should be filled in by the student.
Clauses 8-10 should be filled in by the advisor/head of the teaching committee for Graduate students, head
of department or Dean.
All the following documents must be attached:
- CV and list of publications
- Masters degree approval certificate or verification
- Grade point list for Bachelors and Masters degrees
- At least two letters of recommendation, one of them being from the student’s PhD advisor. Prepare as
detailed in recommendation letter guidelines.*
An application lacking any of the above documents, or not fulfilling the scholarship conditions, will not be
considered.
The list of publications should include:
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Papers which have been accepted for publication or have been published.
Papers which have been submitted but not yet accepted.
Studies for which work has been concluded should be mentioned. It is worth explaining the results that are
to be included in the publication.
An explanation about the type of journal and its importance.
The applicant’s place in the order of authors, as well as his or her contribution to the results.
The list of conference presentations should include:
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Who gave the oral presentation
The applicant’s contribution to the results presented in the conference.
The importance of the conference.
The location of the conference.
*Letters of Recommendation:
At least two and no more than four letters of recommendation should be attached to the application. One of the
letters must be from the PhD advisor. It is a good idea advisable to include letters from people outside the
University, as well as from abroad. In addition, the Kreitman School Assessment Form should be attached to each
letter. If the applicant has more than one advisor, their letters will be considered as one recommendation. Please
refer to the following points in the letters of recommendation: Originality; creativity; the applicant’s analytical
ability; technical capabilities; independence; critical way of thought; general knowledge on the research subjects and
on the relevant literature; diligence.
Recommendation letters which do not meet the criteria will be disregarded.
Name of Scholarship / Name of Award: ______
Faculty:__ _ Department:__ _
Internal / External student
1. Applicant’s Personal Details
Family name: __ First names: ___ I.D.
Year of birth: __ Country of birth:_ _ Year of Aliya:_ _
Citizenship: _ Sex: M/F Marital status: Married/divorced/widowed
Address: _ email: _
Department: __ Degree studying towards: ___ Degree track:__ _ Start date:__ _ Expected end date: _
Names of advisor/s: ___
Name of bank: _ Branch no. _ Account no. _
2. Declaration of work hours scope
Planned places of work during the coming academic year of any scope* (not within the Ben-Gurion
University of the Negev)
Place of work: _ Weekly hours:
*I hereby commit to notify the department secretariat of any changes in my job placements.
3. Academic Studies
Years
Name of Institution
Degree
Grade Point Average
Bachelors
Masters
Grade point average: _
Thesis grade: _
Final exam grade: _
PhD
Date of candidacy exam: _
Attach a list of courses and grades.
(only for
prizes)
4. Scholarships, awards and stipends
Year
Award
5. Names of Advisors and Referees
Name
Position
Institution
6. Detail required academic assignments: (attach a list of lab courses and exercises including their year).
_
7. Research Description: _
8. Considerations for presenting the student for the scholarship / award:
The applicant’s advisor should summarize the applicant’s achievements detailed in the previous clauses,
stressing emphasizing the uniqueness of the applicant’s research field, and its relevance to the Department
and its research discipline. _
9. Applicant, advisor and faculty commitment to the conditions detailed in the statute:
We, signed below, hereby commit to adhere to all conditions related to the scholarship / award as detailed
in the statute and guidelines.
Date: _Applicant’s signature: _____________________
Date: _Advisor’s signature: _____________________
10. The signatures constitute a financial commitment for providing matching payments as detailed below.
This commitment is valid for 4 years beginning in the academic year ___________ and in accordance with
the" Kreitman" and "Negev" scholarships statute.
This commitment is valid for 5 years beginning in the academic year ___________ and in accordance with
the "Darom" scholarships statute in the direct track.
Kreitman
Scholarships
Negev
Scholarships
Scholarships (14
monthly stipend
portions in total
per student)
Negev
Scholarships
Faran
Scholarships (12
monthly stipend
portions in total
per student)
Zin Scholarships
(10 monthly
stipend portions
per student)
Darom
Scholarships
The Direct
Track -Bsor
Scholarships
(12 monthly
stipend
portions in
total per
student)
Darom
Scholarships
The Direct
Track -Lachish
Scholarships
(10 monthly
stipend
portions in
total per
student)
Kreitman School
7 portions
6 portions
5 portions
6 portions
5 portions
Faculty /
5 portions
4 portions
3 portions
4 portions
3 portions
Department
Advisor
2 portions
2 portions
2 portions
Date: _ Advisor’s signature: ______________________
Date: _Head of Department signature: ______________________
Date:_ Dean signature: ______________________
2 portions
2 portions