Affix Photo MS – Training Centre for Development Co-operation P.O. Box 254, Arusha – Tanzania; Tel +255 27 254 1044/6/8; Mobile: +255 754 651715; Fax: +255 27 254 1042 Email: mstcdc@mstcdc.or,tz; mollelh@mstcdc.or.tz; haikag@mstcdc.or.tz Scholarship Application Form Notes: The filling and submission of this scholarship application form does not in any way constitute a guarantee of award of scholarship. MS TCDC reserves the right to determine the award and size of award. The decision of the scholarship committee of MS TCDC shall be deemed final. The form is available free of charge and NOT FOR SALE Any applicant to the short courses, Certificate, Diploma, Degree or Masters programmes are eligible for scholarship. Scholarship is for TUITION ONLY and does not cover living costs and other expenses. The scholarship award shall range from 25% to 100% based on assessed need and available resources. Tuition scholarships are available to applicants from developing countries only (Please see OECD classification to see if your country qualifies) Please send the completed application form to the Principal, MS TCDC at the above address. SECTION A: General Information Name: ______________________________________________________________________________ Date of Birth: ___________________________________ Sex: ________________________________ Address: ____________________________________________________________________________ Phone: ___________________________________ E-Mail: ___________________________________ Nationality: _________________________________________________________________________ Estimated family annual income: ___________________________ Course applied for (Tick as appropriate) Certificate in Governance & Development Diploma in Governance & Development BA Development Studies MSc. Governance & Leadership Short Course ( Specify)__________________________________________________________ SECTION B: Award Information Education High School: _________________________________________________________________________ Address: ____________________________________________________________________________ From (Yr): _____________________ To: ____________________ Grade attained: _______________ College/University:___________________________________________________________________ Address: ____________________________________________________________________________ From (Yr): _____________________ To: ____________________ Grade attained: _______________ College/University:___________________________________________________________________ Address: ____________________________________________________________________________ From (Yr): _____________________ To: ____________________ Grade attained: _______________ College/University:___________________________________________________________________ Address: ____________________________________________________________________________ From (Yr): _____________________ To: ____________________ Grade attained: _______________ Statement of motivation: Please state below in 200 to 350 words why you should be considered for scholarship. We are interested to know (i) how you have been of service to the community (ii) how the course selected will enhance your current or future career and service to the community and enhance your leadership capacity (iii) any peculiar social characteristics that sets you apart from the rest. ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ___________________________________________________________________________________ ___________________________________________________________________________________ ___________________________________________________________________________________ ___________________________________________________________________________________ Reference: Please provide name and contact of a professional or academic referee that can confirm/corroborate the information given in this form. Name: ______________________________________________________________________________ Relationship: __________________________________ Tel & Email: __________________________ SECTION C: Application attachments & Checklist Duly filled application form Updated CV 1 letter of reference Any relevant support documents SECTION D: Declaration I certify that the information provided in this application form is complete and true to the best of my knowledge and do understand that any award shall be cancelled forthwith should anything be proven to the contrary. Signature: ______________________________________________ Date: _______________________ FOR OFFICIAL USE ONLY Scholarship application Approved Rejected Reason(s) for rejection _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ Award 100% 75% 50% 25%