Citadel Capital Scholarship Foundation Application Form Insert photo here. Personal Information: 1. Full name and Title (Mr., Miss, Mrs.) __________________________________________________________________ 2. Sex: M___ F___ 3. Date of Birth (Day/Month/Year): ___/___/____ 4. Marital status: Single ___ Married ___ Divorced ___ Widowed ___ 5. Number of dependants (if applicable): _______________________________ 6. Do you hold any other nationalities Yes__ No__ 7. If yes, please state: _____________________ Contact Details: 8. Home address: __________________________________________________________________ __________________________________________________________________ 9. Other contact address (if applicable): _______________________________________________________________ _______________________________________________________________ 10. Home telephone: ______________________ 11. Mobile number: _______________________ 12. E-mail: ________________________ 13. Next of kin, name/relation: _________________________________________/________________________ 14. Next of kin address: _______________________________________________________________ _______________________________________________________________ 15. Next of Kin phone number: ______________________ Study Program of Interest: 16. Name of University: ____________________________________________ 17. Country: _____________________________________________________ 18. Area of Specialization: ___________________________________________ 19. Degree objective: MA___ MSc.___ MBA___ PhD (or equivalent)___ 20. Have you been officially accepted at your university of choice? Yes______ No______ 21. Have you applied for any other scholarships? Yes______ No______ 22. If yes, please list the scholarships you have applied for and whether or not you have been accepted: _______________________________________________________________ _______________________________________________________________ _______________________________________________________________ _______________________________________________________________ 23. Educational Background: Name of Date School/ (from/to) University Secondary Degree obtained Main Course Study Date of received Grade University 24. Professional Background (starting with the most recent): Name Employer of Position Duration (from/to) Country 25. Are you a member of any NGO or active in any philanthropic or volunteer initiatives? Yes___ No___ 26. If yes, briefly describe the nature of your activities: _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ 27. Statement of purpose: Please state in no more than 250 words why you wish to pursue your studies in your chosen field/university and how you believe you can benefit personally and professionally from your studies in the future. _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ 28. Costs: List below the total expected costs for 1- tuition 2- living expenses. Please state the duration of the program of study as well. Attach back-up documents for this information to your application: i. Tuition:___________ ii. Living Expenses (annual):___________ iii. Duration of program:___________ The required documents to be submitted in your file are - Completed and signed application form for the Citadel Capital Scholarship Letter of acceptance to ONE university of choice (photocopy) Photocopy of the completed application form submitted to the university (if the form was submitted online, ask for a pdf copy from the university) An updated C.V Two reference letters (one academic and one professional) Military service certificate -for males (photocopy) Please submit printed and signed application along with the above documents to: By Regular Post: Citadel Capital Scholarship Foundation P.O Box 29 Postal Code: 11516 Cairo, Egypt By Fedex: Citadel Capital Scholarship Foundation Hold at Fedex Garden City Office I certify that the information provided in this application is accurate and complete. I understand that withholding relevant information requested herein or giving false information will make me ineligible for the Citadel Capital Scholarship Program and will result in the cancellation of the scholarship. Signature:……………………………………………………Date:……………………. .