Palau National Scholarship Board
PO Box 1608
Koror, Republic of Palau 96940
Telephone: 488 - 3608
Fax: (680) 488 – 3602
Application for CONGRESSIONAL
SCHOLASTIC AWARD (CSA)
(For Citizens of the Republic of Palau only)
Please use typewriter or block letters in ink. Submit the completed application to the
Palau National Scholarship Board on or before the designated deadline. Late and
incomplete applications or those without supporting documents will not be considered.
Read the “Instructions to Applicant” on the reverse side of this application form.
Name of applicant (Last, First, Middle)
Citizen of
Mailing Address
Resident of
Sex
Date of Birth
Place of Birth
High School (s) Attended
Date of Graduation
Cumulative GPA _____________________
College or University applied to
Field of Study _______________________________
______________________________________________
I hereby declare that the information I have given in this application is true and correct to the best of my
knowledge and belief.
___________________________________________
Applicant Signature
FOR OFFICE USE ONLY
Palau Passport
High School Transcript (s)
Birth Certificate
SAT Score
Certificate of Graduation
TOEFL Score
School Acceptance Letter
FORM CSA
REV 12/2008