Hong Kong Schools Alumni Federation Scholarship Foundation
2016 HKSAF Scholarship for Undergraduate Studies at US Colleges
Application Form
I
Personal Particulars
Name (English) __________________________________
(Surname)
(Given Name)
(Chinese) ________________
Date of Birth _______________ Place of Birth __________________
(MM/DD/YY)
Nationality _________________________
Sex ______
Reside in HK since _____ (year)
Citizenship __________________________
Home Address _____________________________________________________________________________
Tel. No. ________________ Mobile Phone No. __________________ E-mail ________________________
II
Family Particulars
Father’s present employer : ___________________________________________________________________
Position _____________________________________________
Employed since ________________
Mother’s present employer : __________________________________________________________________
Position _____________________________________________ Employed since ______________________
Parents’ Highest Level of Formal Education – Father : ___________________ Mother : ___________________
Total Number of Persons in Household & Relationship with Applicant:
Name
Age
Relationship
Name
Age
Relationship
__________________
_____
_______________
___________________ _____
________________
__________________
_____
_______________
___________________ _____
________________
__________________
_____
_______________
___________________ _____
________________
__________________
_____
_______________
___________________ _____
________________
Page 1
III
Academic Information
Current School: ______________________________
Current Level : ___________
Other Secondary Schools you have attended (if any) : ______________________________________________
IGCSE Results:
Grade 5** / A* :____________________________________________________________________________
Grade 5* / A:______________________________________________________________________________
Grade 4 / B: _______________________________________________________________________________
Grades of all other subjects taken : _____________________________________________________________
SAT I : Test Date: __________
Scores: Critical Reading _______
Writing _______
Math _______
Test Date: __________
Scores: Critical Reading _______
Writing _______
Math _______
SAT II :
Test Date: __________
Test Date : __________
Subject _________________ Score: ______
Subject ___________________ Score : _______
Subject _________________ Score: ______
Subject ___________________ Score : _______
Subject _________________ Score: ______
Subject ___________________ Score : _______
ACT Scores (composite & all subjects taken) : ____________________________________________________
__________________________________________________________________________________________
_______________________________________________________________________________________________________________________________________
TOEFL :
Test Date: __________ Score: ______ ,
Test Date: ____________ Score: _______
List ALL US colleges / universities you have applied for the academic year of 2016/2017 :
College/University & Intended Major
College/University & Intended Major
1
_______________________________________
2
____________________________________
3
_______________________________________
4
____________________________________
5
_______________________________________
6
____________________________________
7
_______________________________________
8
____________________________________
9
_______________________________________
10
____________________________________
Page 2
IV
A
B
C
D
V.
A
Extra-curricular Activities since Secondary 3
Please provide the following information on a separate sheet of paper:
Extra-curricular Activities (list member of clubs, positions held, work involved and years of service)
Community Service (list member of organizations, positions held, work involved and years of service)
Sports (list member of school teams and awards received)
Honors and Awards (description of awards with names of organizations)
Financial Background
Total Annual Household Income (as reported to Hong Kong Inland Revenue Department)
April 1, 2013 to March 31, 2015
HK$ ____________________
Expected Annual Household Income April 1, 2015 – March 31, 2016 : HK$ __________________
B
My parents own the property my family is now residing
Yes (
)
No (
)
The estimated current market value of the property is HK$ _________________ subject to a mortgage –
Yes (
)
No (
). The outstanding mortgage loan (if any) is HK$ _____________________
C
If your parents do not own the property, how much rent are they paying per month? HK$ ___________
D
Do your parents own other properties?
Yes (
total estimated current market value?
E
)
No (
). If you answer ‘yes’, what is the
HK$ ___________________
Ownership of Business:
Does your father or mother own any business?
Yes (
)
No (
please provide company name and the nature and scope of the business.
). If you answer ‘yes’,
________________________________________________________________________
VI
Overseas Studies & Other Scholarships
A
Have you previously studied outside Hong Kong? If so, give dates, institutions attended and course
of study.
____________________________________________________________________________________
____________________________________________________________________________________
B
If you are currently applying or intend to apply for other scholarships or forms of financial
assistance in relation to your proposed overseas studies, please list the names of the scholarships or
forms of financial assistance of your applications.
____________________________________________________________________________________
____________________________________________________________________________________
Signature of Applicant
___________________________
Page 3
Date
_______________
2016 HKSAF Scholarship – Notes to Applicants
Scholarship Award & Duration
1
2
3
Scholarships will be offered for four years subject to the recipient’s achievement progress during matriculation.
Value of the scholarship will be adjusted taking into account the actual costs of attendance, other awards held
concurrently by the recipient to finance his/her undergraduate studies and the recipient’s financial need.
Successful qualified applicants attending Harvard University, University of Southern California or University of
Rochester may be offered full scholarship to pay for tuition and room & board.
Eligibility
An applicant must fulfill the following criteria:
1
Be a permanent resident of Hong Kong,
2
Has received at least 3 years of continuous education, and is currently enrolled as a full-time student, in a
school in Hong Kong,
3
Has obtained at least 6 subjects at A* or A (in one sitting) in the International General Certificate of Secondary
Education (IGCSE), or a score of 1950 or above in SAT I, or a score of 28 or above in ACT,
4
Has successfully gained admission to any U.S. four-year college or university as a freshman for the first time in
the Fall of 2016, and
5
Prove financial need
Application
Application Form may be downloaded from Hong Kong Schools Alumni Federation Scholarship Foundation web-site:
www.hksaf.org
Application Deadline : Completed Application Form with the relevant documents should be sent by regular mail to the
following address on or before January 30, 2016 (post date) : Hong Kong Schools Alumni Federation Scholarship
Foundation, RM1006, Clifford Center, 778-784 Cheung Sha Wan Road, Kowloon, Hong Kong
Documents to be submitted with the Application Form :
1
2
3
4
A Letter of Recommendation with transcript by the Principal of your current school,
IGCSE /SAT/ACT/TOEFL scores (updated scores may be submitted separately not later than February 29, 2016)
Copy of parents’ most recent tax return(s), and if parent(s) owns any business, copy of the most recent tax
return(s) of the company/companies,
Copy of application to Harvard University, University of Southern California & University of Rochester, if
applicable; alternatively, copy of application to one other US college.
Selection Procedure
1
2
3
Short listed applicants will be invited to attend an interview in April 2016 in Hong Kong. They will be notified of
the interview date by telephone or email in March/April.
A home visit to selected applicants may be conducted after the interview. Selected applicants will be notified by
telephone or email of the date of the home visit.
The successful applicant will be notified of the scholarship award by email in May/June 2016
Inquiries
1
2
Hong Kong : Ms. Sincere Yip, Tel.: 96834152, e-mail : sincereyip@hotmail.com, Ms. Angel Kong, e-mail :
angel.kong@gmail.com, Ms. Catherine Leung, Tel.: 97478252, email : chleung@gmail.com, Mr. Andrew
Sundjaja, email: asundjaja@gmail.com, Mr. Eric Tsang, Tel.: 23704433, e-mail: eric@welllinkhk.com
California, USA : Ms. Mimi Ho, Tel.: 1-626-281-8179, e-mail : info@hksaf.org