SJI International S c h o o l M a l a y s i a
IB Diploma Scholarship
Application Form: for August 2016 applications
Closing date: Friday, 19 February 2016
The International Baccalaureate Diploma Programme (IBDP) is a 2-year educational programme primarily
aimed at students aged 16-19. Success in the IBDP offers students the opportunity to gain access to the
best universities in the world.
St Joseph’s Institution International School Malaysia (SJIIM) will offer scholarships to students entering
Year 12 in August 2016.
The Scholarship Programme aims to enable deserving students to benefit from our unique holistic Lasallian
education, regardless of financial means.
Please note:
1. SJIIM scholarships are awarded to outstanding students to study the IB Diploma Programme
(IBDP) at SJIIM for a period of 2 years.
2. The scholarship will be awarded to the most outstanding applicants with excellent quality of mind, active
participation in extra-curricular activities, positive personal qualities and strong communication abilities.
Personal Statement
The Personal Statement provides you with an opportunity to express your individuality and allows us to get a
better picture of you as an individual.
In 200 words or less, describe a significant experience that you have had, and evaluate its
impact on you.
This experience may be an achievement, a failure, a risk or any other experience that was important to you.
Please word-process your Personal Statement, with your name in the top left-hand corner, and email it as a
Word or PDF document along with your Application Form.
Additional supporting material
You may submit any information, certificates or testimonials that you believe will support your application.
Please include your name at the top left hand corner of each additional document and email it
with your application.
Timeline
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Closing date for applications: Friday, 19 February 2016.
Selection tests: Saturday, 27 February 2016.
Interviews: Shortlisted candidates will be invited to interviews in early March 2016.
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Application Form
Please affix a
recent photo
Date of Application:
Personal Particulars
Name:
Date of Birth:
Gender: M/F
Nationality:
Race:
Religion:
NRIC/Passport Number:
Date of Issue:
Address:
Email Address:
Telephone (Home):
Telephone (mobile):
Medical complications/treatment and medications:
Please tick the appropriate
box regarding Combined
Gross Family Income if you
are applying for a meanstest scholarship:
□
RM250,000-300,000 □
RM300,000-350,000 □
RM350,000-400,000 □
RM400,000-450,000□
Above RM450,000 □
Below RM 250,000
Family Particulars
Name of Father:
Occupation:
Email Address:
Mobile Number:
Name of Mother:
Occupation:
Email Address:
Mobile Number:
Please indicate if parents are deceased, separated or divorced:
Siblings (indicate their ages and current school/occupation):
If you do not reside with your parent(s):
Name of Guardian:
Email Address:
Occupation:
Mobile Number:
Address (if not same as above):
Particulars of Current School
School Name:
Present level/grade in school:
School Address:
Principal’s Name:
Principal’s/School’s Contact Number:
Email Address:
Emotional / Medical History
Have you ever received any educational or psychological testing (e.g. for dyslexia, autism etc.)? Do you have any
medical condition or suffered any emotional difficulties which the school needs to be aware of? If YES, please
provide details below.
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Language Ability
What is your first language?
If not English, how long have you been learning English?
Which language(s) do you speak at home?
Activities Record
Where applicable, please indicate the level of your involvement and the positions of responsibility held.
Clubs/Societies/Uniformed/Youth groups:
Sports:
Performing arts/Musical instruments:
Social/Community work:
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Applicant’s Declaration
I declare that the information provided in support of my scholarship is true and accurate.
Name of Applicant:
Date:
Signature of Applicant:
Parent/Guardian’s Consent
I support this application by my child/ward for the SJI International Malaysia Scholarship for the study of the IB
Diploma Programme in 2016-2017.
Name of parent/guardian:
Date:
Signature of parent/guardian:
Application Checklist
Use the following to ensure you have all the necessary documentation for your application:
1. Fully completed Application Form, signed by your parent/guardian
2. Personal Statement
3. Supporting documentation
4. Copies of official school transcripts for the past 3 years
5. One recent passport sized photograph - attached to the Application Form in the space provided
6. If you are Malaysian/Permanent Resident, please attach photocopies of your NRIC
7. If you are applying for a means tested scholarship please provide financial details
If you have any questions, please email us at: enquiries@sji-international.edu.my
Submission
Please complete all sections in the Application Form as fully as possible, but no later than Friday, 19 February
2016. Remember to have a parent/guardian sign the form before submitting it.
Please email the completed Application Form and all supporting documentation to:
stuartglascott@sji-international.edu.my
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