English Language Scholarship Application Form

This Application form is for students wishing to apply for funding to support English language studies. Please provide the following documentation alongside your application form:

  • Proof of enrolment on the British Council English Language Course, another English Language Institution approved by Prospect Burma.
  • A reference from an individual who can write in support of your character and academic abilities. Please also provide the contact details of your referee in the appropriate section of the form.
  • Photocopies of any Identification documents (e.g. passport, identity card) that you currently hold

All forms must be submitted by the following deadlines for each term:

  • Term 1 (Jul-Sep): May 31
  • Term 2 (Oct-Dec): Aug 31
  • Term 3 (Jan-Mar): Nov 30
  • Term 4 (Apr-Jul): Feb 28

Please submit all applications to:

  1. YOUR PERSONAL DETAILS

Full Name: / Aliases (if any): / Ethnic origin:
Date of Birth / Place of Birth / Male/Female / Married/Single / No. of Children
Permanent Address:
City/ State: / Postcode: / Country:
Current Mailing Address:
City: / Post Code: / Country:
Where are you making this application from: (province/state, country)
Telephone:
(country code & number) / E-Mail:
  1. DETAILS OF YOUR ENGLISH LANGUAGE COURSE:

Training Institute / British Council/Cetana (delete as appropriate)
Entry Level:
Preferred Date: (Month/Year) / Expected finishing date: (Month/Year)
Number of terms you plan to study:
  1. REFEREES

Please provide the details of a referee who can vouch for your character and abilities.

Name
Employer
Position
Address
Telephone
Email
  1. FAMILY INFORMATION

If either or both parents are retired or deceased, please give their previous occupation

Father:
Name / Occupation:
Country of residence:
Is your Father Retired? / Is your Father deceased?
Mother:
Name / Occupation:
Country of residence:
Is your Mother retired / Is your mother deceased?
Have either of your parents attended university?
If yes please give details of your parents education below (course; level (eg. undergraduate/postgraduate/doctoral); country):
Have any of your siblings attended university?
If yes please give details of their education below(name; course; level (eg. undergraduate/postgraduate/doctoral) and country):
  1. PREVIOUS EDUCATION

  1. Name & location of Secondary School attended:

b. Subjects studied: / Examinations passed with dates:
c. Details of College/University attended: / Examinations passed with dates:
  1. BIOGRAPHY:

In an essay of 300 words, please give details about your upbringing with particular reference to Burma's social and political situation.


  1. FUTURE PLANS:

In an essay of 300 words, please tell Prospect Burma about your future plans and how attending an English language courses will help you to fulfil these plans.

8. DECLARATION

To the best of my knowledge, the information I have presented in this application is accurate. I can confirm that I have not knowingly fabricated or falsified any information provided in this document. I understand that if I am caught providing false information my Prospect Burma scholarship will be cancelled with immediate effect, and I will be blacklisted from applying for future English Language of University scholarships from Prospect Burma.

Signed:

Date:

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