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
School/
University
Date
(from/to)
Degree obtained
Secondary
University
24 . Professional Background (starting with the most recent): of Position Duration
(from/to)
Name
Employer
Main
Course of
Study
Date received/ expected
Grade
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.
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
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_____________________________________________________________________
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_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________

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:___________
Completed and signed application form for the Citadel Capital Scholarship
Letter of acceptance to ONE university of choice (photocopy)
University application form (if form was submitted online, ask for a pdf copy from the university) (photocopy)
An updated C.V
Two reference letters (one academic and one professional)
Military service certificate -for males (photocopy)
Please make sure you do not submit originals where you are required to submit photocopies. Application packages are not returned to applicants.
If you are shortlisted you will receive a phone call from CCSF during the period from May 10 th - June 10 th . If you cannot be reached by phone, CCSF contacts your next of kin and emails you until you are reached.
Interviews are conducted –in person- during the period from the second half of
May until mid-June.
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:…………………….