Nottingham Roosevelt Memorial Travelling Scholarship

NOTTINGHAMS ROOSEVELT MEMORIAL TRAVELLING SCHOLARSHIP

For those aged 21-35 on 1st September 2018 employed in the private, public or third sector, and living or working in the City or County of Nottinghamshire.

Application – Personal Particulars Only

Applicants Name
Mr/Mrs/Miss/Ms
(please indicate as appropriate)
Home address
(including Post Code)

Home Telephone Number (incl STD) / Work Telephone
Number (incl STD)
Mobile Number / Email
Date of Birth / Age in Years (on 1st September)
Parents/Next of Kin Name
Parents/Next of Kin address
(including Post Code)
Parents/Next of Kin telephone number
Employers name
Line managers name:-
and department
Employers address
(including Post Code)
Your present job/ position
(please describe as fully as possible indicating responsibilities)
Previous Work Experience
Education
(after age 11) / Subjects / Grades
College/University / Subjects / Qualifications
Part-time/Full-time/ Sandwich/Correspondence
(please state)
Hobbies/Pursuits/Interests outside of work
Have you ever been abroad other than on holiday?
If so where and when and in what connection?
Have you ever been to the USA before?
If so where and when and in what connection?
Do you belong to any organisation?
Formal or otherwise
How did you hear about the Scholarship?
(please tick) / Through my company/work
Through a friend/family
Evening Post
Through the scholarship website
Other (please be specific

I confirm the above mentioned information is correct and if selected I will continue to support the scholarship.

Signed:Date

Now on the next page tell us why you should be a Roosevelt Scholar

On the page below describe why you wish to be selected and what you propose to do and then describe how you expect this to benefit yourself, your employer and Nottinghamshire upon your return

You may copy and paste text from another document/application but please take care to check the formatting before submitting your application. Please note the limits on the number of words per section.

Please give the name and address of two referees from whom character references may be taken if after the first interview you are successfully short-listed. References will not be taken up until after the first interview round is complete.

Employer Reference / Personal Referee
Name / Name
Address / Address
Post Code / Post Code
Telephone Number / Telephone Number
Email Address / Email address

Return to:secretary@rooseveltscholarship.org

Website:

Nottingham Roosevelt Memorial Travelling Scholarship

Charity Number: 512941