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Please return all three pages of this form to the address of our coordinators

Tax ID: 20-8167852

MANKON FORUM SCHOLARSHIP INITIATIVE (MFSI)

APPLICATION FORM

All applicantsfor this scholarship must complete an application form in order to be considered. This Scholarship is intended to assist children from Mankon in last year of primary school who will be entering secondary schools next school year. Special focus is directed at economically disadvantaged children. Mark N/A where there is no answer to a question in the form.

(See selection criteria in handbook)

PART I: Personal Information

NAMES: First: ___ANYE______Middle:__ _ELVIS______Last (family): ATUETAH______

Date of birth: _05_/26__/1997____ Sex: Male F

Father’s Name: _CHRISTOPHER ATUETAH______Mother’s Name: LINDA ATUETAH ______

Quarter (in Mankon): NTAMAFE ______Caretaker’s Contact phone No: 77712430 ______

I have ___ 5 __ Brothers and 2______Sisters. 3______have been to College.

One or both Parents Dead: Father _NO______Mother__NO______

How can we contact you with results or for more information (add a phone number): ______777123430______

PART II: Academics and Education

List the last 3 Institutions that you have attended over the past SIX years:

Name of School / From / To / Certificate received
CS NTAMBENG / 2006 / Present
GS NTINGKAG / 2003 / 2006 / TRANSFERRED

List in which you passed the Common Entrance: ______

List three Choices of Secondary School(s):

1st GHS MANKON ______2nd GBHS BAMENDA ______3rd SHC MANKON ______

Will you accept to enroll at GHS Mankon if you win this scholarship? YES

Essay Writing

What will you like to do after you graduate from college? And what activities are you involved with in your school?(Not more that 500 words on a separate sheet paper)

PART III: Financial Information

Name the person or Caretaker who pays your school fees FATHER______

State the principal type of work your father does WINE TAPPER______

State the principal type of work your mother does FARMING______

State the average monthly income in your home DON’T KNOW______

State the type of gainful job your brother/sister does BUSINESS-D’LA____, BUSINESS B’DA______

State any gainful activity you do during the holidays FARM WITH MY MOTHER______

PART IV: School Records.

Section to be completed by your last SCHOOL.

PART IVa:

Have your Headmaster/principal enter your last year results in school into the table below. If the space is too small, you may have the results signed and attached

Subject/Course / Score 1st term / Score 2nd term / Score 3rd term / Rank

Overall position of student in class: Number____ out of ______.

I rank this student among the:

Top 5% Top 10% Top 25% Top 50% of the class

PART IVb: Information about School Authority completing this SECTION

Name of Headmaster/TeacherPrincipal: NCHE NIBA NDE______Phone no. 77612345______

Name of School: CS NTAMBENG ______

PART V: RECOMMENDATIONS (2 persons, one being your class teacher)

Names of person(s) writing your recommendation (1) ______(2)______

Relationship to applicant: TEACHER (1) ______(

2) ______

Phone no. (1) ______(2)______

PART VI: Certification and Signature:

I authorize the Board of Directors and Sponsors to obtain complementary information from other sources and relevant authorities, if needed (school enrolment, academic records, examination results, or school attendance records).

I agree that such information be used for processing my scholarship only.

If awarded the scholarship, I agree to abide by the conditions of the award as amended from time to time.

As a grantee my name, picture, etc, can be used in the reports and other documents of the Forum.

I ANYE ELVIS______certify that all the information entered on this application is true and correct to the best of my knowledge. I accept that should any of this information turn out to be false, my application will be disqualified. I also accept that this application does not automatically grant me the rights to any scholarship.

Name of Applicant: ANYE ELVIS ATUETAH ______Signature ANYE ELVIS__

__ Date: 02/18/08______

DISCLAIMER:

Completion of this application form does not automatically qualify an applicant for an award. The board of directors reserves the rights to accept or decline any application, vary the scholarship amount as deemed necessary and investigate any fraudulent acts.

SUBMISSION OF APPLICATION FORM

Before you turn in your application (See announcement for local addresses) please check the following boxes to ensure that it includes the following:

The Scholarship Application Form provided has been completed and signed.

Your Principal/Headmaster has filled out your entire last year results

Your teacher has written a brief recommendation on your behalf.

A photocopy of your birth certificate has been enclosed

Did you enclose the 200-500 word Essay on why you are applying for scholarship

and how you think the scholarship will help you?

APPLICATION INSTRUCTIONS

The MFSI scholarship is intended for academically strong but economically disadvantaged students from Mankon. We encourage every student who aspires to continue his/her education post primary school to complete the form and submit all required documents. The board of directors will select the most qualified applicants for scholarship award before the end of June of each award year. These instructions are to help our applicants compile their documents with minimal misinterpretations. However, if you have any further questions, you are invited to contact us at our mailing address or by email at .

PART I: PERSONAL INFORMATION

Enter Your names as they appear on your birth certificate.

In entering your date of birth, START with the MONTH, then the DAY of the month and finish with the YEAR of birth. Provide a photocopy of your birth certificate as part of your documents.

Provide the names of your legal parents as they appear on your birth certificate. We also want to know whether both of your parents are alive or death. If they are both alive, enter N/A in the provided spaces. You should also enter the contact phone number of your primary caretaker if available. We strongly encourage every applicant to provide some sort of contact information so we can get back to you with our final results where applicable.

Provide us with information about how many brothers and sisters you have. In addition, we want to know how many of them have been to college (secondary school).

PART II: ACADEMICS AND EDUCATION

Enter in the provided spaces the schools you have attended and the period you were at that school. If you had a certificate by the time you left that school, enter it in the provided box, else write N/A.

Also we want to know your first three choices for secondary schools. If you have already taken the common entrance, provide us with your LIST AS WELL AS YOUR SCORES.

Write a composition bout yourself and what you hope to be in the future. This should be done by the applicant. Also, we want to know how our various applicants have been involved in activities within their school or quarter. We recognize that not every applicant would have done so. We encourage applicants to discuss their ideas with parents and teachers but the final draft has to be written by the applicant. We will accept both typed and hand written essays. If the board determines that the draft was not written by the applicant, this will be grounds for disqualification. Your essays should be more than 200 words but less than 500.

PART III: FINANCES

Provide us with information as to who has been paying your school fees, what job your parents do principally as a source of income and an estimate of their earnings per month. In addition, provide us with information as to what types of jobs your siblings do. If you do any activities that generate income during the holidays, provide that information else write N/A.

PARTS IV AND V: SCHOOL RECORDS

This section needs to be completed by your school. Your headmaster should review your school records and fill the required information for the last school year. If the space is too small, they can attach extra sheets. The person completing this section MUST provide us with contact information as these records would need to be confirmed and verified. Failure to provide this information will be grounds for automatic disqualification.

In addition to your school records, we will like to get at least one recommendation letter. Family members are discouraged from providing such letters. Ideal people would include your current or past class teacher.

PART VI: CERTIFICATION AND SUBMISSION

You must read and sign this section before submitting your application. Your signature confirms that you have read the instructions and complied with them to the best of your abilities.

To minimize your expenditure, we have provided local addresses for you to drop your applications at. We have taken measures to ensure that the application process is made as accessible as possible. We DO NOT encourage applicants to mail their applications to our office address directly. If you have any better suggestions for MFSI scholarship and its applicants, please do not hesitate to contact us by email or phone.

MFSI is a group comprised of sons, daughters and well wishers of Mankon that seek to encourage education through scholarship and academic support. We are a non political, non denominational, not for profit organization and every individual who meets the requirements for consideration cannot be disqualified on the basis of gender, sexual orientation, educational institution, race, religion or political affiliation.

Mankon forum scholarship initiative. Scholarship application form. MFSI.saf.mankon3

MFSI,c/o Fausta Ditah, 4768 washtenaw Ave Apt B5, Ann Arbor Michigan 48108