GULF UNIVERSITY FOR SCIENCE & TECHNOLOGY (GUST) GRADUATE SCHOLARSHIP COMMITTEE SCHOLARSHIP APPLICATION FORM I - APPLICANT INFORMATION Full Name: Date of birth: Civil ID Number: Marital Status: No. of Children: Employment Status/Position: Passport Number*: Expiration Date: Date of Issue: Permanent Address: Email: Telephone: II - ACADEMIC INFORMATION UNDERGRADUATE DEGREE Degree obtained: University name: Student ID No.: Country/City: Major: CGPA*: Date of Graduation: MASTER’S DEGREE Degree obtained: University name: Student ID No.: Country/City: Major: CGPA*: Date of Graduation: III - SCHOLARSHIP LOCATION University name: Country/City: State/Province (if applicable): Major: IV - CONFIRMATION OF APPLICANTS DETAILS I, the student ___________________________________________________, confirm the following: 1. That I am not employed in any institution/company outside the university. Signature of Applicant: 2. That I do not have a scholarship from any other government or private institution, and have never been dismissed from a scholarship previously. Signature of Applicant: 3. That I will provide Gulf University for Science & Technology and the Kuwait Cultural Office in Washington D.C. a detailed report on my academic progress. 4. That I will opening a student file with the Ministry of Higher Education (MOHE) to ensure that my degree will be authenticated in the Equivalency Department in the MOHE after my graduation. 1 GULF UNIVERSITY FOR SCIENCE & TECHNOLOGY (GUST) GRADUATE SCHOLARSHIP COMMITTEE SCHOLARSHIP APPLICATION FORM Signature of Applicant: Date: 5. That I will provide the Kuwait Cultural Office in Washington D.C. and Gulf University for Science & Technology all the academic details of the university I am studying in, and I will inf orm the university that I am studying in to provide the Kuwait Cultural Office in Washington D.C. and Gulf University for Science & Technology any academic information they may request. Signature of Applicant: Date: V – SCHOLARSHIP DOCUMENTS REQUIRED Completed application form and signing the declaration statements indicated in the application form; Copy of the applicant’ civil I.D.; Copy of the applicants passport; Copy of Kuwait nationality; Copy of birth certificate; Attested copies of Graduate Certificate and Detailed Marks Sheet Transcript; Certificate of good conduct; Four (recent) passport size photographs; Result of the medical report certified by the medical entity determined by the University; Unconditional acceptance letter to the intended academic program from accredited college or university approved by the Scholarship Committee; Copy of the students previously obtained academic degrees; An official letter from the Registrar at the university the student has received unconditional acceptance from, which states the major of the student, the date of the commencement of the academic year, and expected graduation date of the student. Student needs to ensure that the university they are accepted in is accredited and recognized by Gulf University for Science & Technology and the Kuwait Ministry of Higher Education (MOHE). VI - DECLARATION OF APPLICANT & SPONSOR I, the undersigned, _____________________________________________________________________________ hereby confirm that I am a Kuwaiti citizen, and I carry nationality number ________________________________ and that my address is __________________________________________________________________________ that my telephone number at my place of residence is_____________________________________________ ____ that my mobile number is____________________________________________________________________ ____ that my fax number is_______________________________________________________________________ ____ that my electronic mailing address is_______________________________________________________________ I declare that all the information stated in this application form is accurate, and I have full knowledge of my legal responsibility in ensuring its soundness and accuracy. 2 GULF UNIVERSITY FOR SCIENCE & TECHNOLOGY (GUST) GRADUATE SCHOLARSHIP COMMITTEE SCHOLARSHIP APPLICATION FORM Furthermore, I pledge, in conjunction with my sponsor, ______________________________________________ to repay all financial expenses that the university has covered for me according to the Executive Bylaws of the Graduate Scholarship Committee which was published in a decree (no.4, reference number: 2011/7/76 dated April 24, 2012) by the Board or Trustees of Gulf University for Science & Technology. I understand that the Graduate Scholarship Committee reserves the right to terminate the scholarship award at any time if the scholarship recipient: a. fails to comply fully with any or all conditions of scholarship, as provided in this bylaw; b. if the behavior of the scholar deems to be unsatisfactory and adversely affect their communit y, home country or the government; c. breaches of obligations stipulated in the regulations, and the recipient shall continue the work or activity after being warned with the committee's consent. d. fails to proceed the scholarship or its determined proced ures prescribed by the University; e. fails to maintain satisfactory progress for two consecutive years or exceeded the permitted period of scholarship. I, the Applicant, hereby confirm that I full understand the above regulations: Name: ______________________________________________________________________________ Employment Details (Position/Company):____________________________________________________________ Signature:_________________________________________________________________________________ ____ Date:_________________________________________________________________________________________ VII – CONFIRMATION OF SPONSORS DETAILS I, the undersigned, _____________________________________________________________________________ hereby confirm that I am a Kuwaiti citizen, and I carry nationality number ________________________________ and that my address is __________________________________________________________________________ that my telephone number at my place of residen ce is_________________________________________________ that my mobile number is________________________________________________________________________ that my fax number is___________________________________________________________________________ that my electronic mailing address is_______________________________________________________________ I declare that all the information stated in this application form is accurate, and I have full knowledge of my legal responsibility in ensuring its soundness and accuracy. 3 GULF UNIVERSITY FOR SCIENCE & TECHNOLOGY (GUST) GRADUATE SCHOLARSHIP COMMITTEE SCHOLARSHIP APPLICATION FORM Furthermore, I pledge, in conjunction with the applicant, ____________________ __________________________ to repay all financial expenses that the university has covered for the applicant according to the Executive Bylaws of the Graduate Scholarship Committee which was published in a decree (no.4, reference number: 2011/7/76 dated April 24, 2012) by the Board or Trustees of Gulf University for Science & Technology. I understand that the Graduate Scholarship Committee reserves the right to terminate the scholarship award at any time if the scholarship recipient: a. fails to comply fully with any or all conditions of scholarship, as provided in this bylaw; b. if the behavior of the scholar deems to be unsatisfactory and adversely affect the ir community, home country or the government; c. breaches of obligations stipulated in the regulations, and the recipient shall continue the work or activity after being warned with the committee's consent. d. fails to proceed the scholarship or its determ ined procedures prescribed by the University; e. fails to maintain satisfactory progress for two consecutive years or exceeded the permitted period of scholarship. I, the Sponsor, hereby confirm that I full understand the above regulations: Name: ______________________________________________________________________________ Employment Details (Position/Company):____________________________________________________________ Signature:__________________________________________________________________ ___________________ Date:_________________________________________________________________________________________ 4