OAS–USTTI PROFESSIONAL DEVELOPMENT SCHOLARSHIPS

UNDER THE

OAS PARTNERSHIPS PROGRAM FOR
EDUCATION AND TRAINING - PPET

“IMT (3G/4G) Mobile Broadband and Mobile TV”

Scholarship Application Form:

Applicants should complete and submit the Scholarship Application Formand the required documents inEnglish, preferably in PDF format, no later than September 21st, 2012, via e-mail , with copy to with the subject matter: “OAS-USTTI ScholarshipsIMT (3G/4G)”

  1. PERSONAL INFORMATION

Full name as it appears on your passport. Please use capital letters for your last name.

Last name First name Middle name

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Date of BirthSex:

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(Day/month/year) Male Female

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Place of Birth

City State or province Country

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Country of citizenship/residency Nationality

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Current Address

Street Apt. number or P.O. Box

City State or provincePostal code Country

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Telephone (with area code)Email:

Home Office

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Emergency Contact Information:

Name:

Last name First nameMiddle name

Telephone (with area code) Email:

Home Office

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Have you everbeen awarded an OAS academicscholarship?

No Yes

If the answer is yes, please indicate the date:

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(day/month/year)

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III. ACADEMIC AND PROFESSIONAL INFORMATION:

POST-SECONDARY STUDIES

Include all post-secondary schools attended, even if you did not graduate. If you have not completed your academic program, include the date you expect to receive your degree. All dates should include both month and year. Indicate your grade point average for each degree received, with the maximum range possible (for example “3.0 out of 4.0 or “4.1 out of 5.0” or “8.9 out of 10”). For institutions that indicate the class of degree conferred, please note the class of your degree (for example, Second Class (Upper Div.), Pass, First Class).

If you are currently enrolled in an academic program, please include your current GPA.

1.

From (mo/yr.) / To (mo/yr.) / Institution and location / Degree
Graduation Date (mo/yr.) / GPA / Field/
Specialization / Class Honors

2.

From(mo/yr.) / To(mo/yr.) / Institution andlocation / Degree
Graduation Date (mo/yr.) / GPA / Field/
Specialization / ClassHonors

3.

From(mo/yr.) / To(mo/yr.) / Institution andlocation / Degree
Graduation Date (mo/yr.) / GPA / Field/
Specialization / ClassHonors

WORK EXPERIENCE

Beginning with the most recent position, please summarize your professional experience (including teaching and research) by listing the name of each employer, your titles or positions, a brief description of your duties, and the dates you held each position. The information given here may be expanded in your curriculum vitae.

Name and location of the institution / Title or Position/Responsibilities / From
(mo/yr.) / To
(mo/yr.)

IV. ESSAYS

These essays are intended to evaluate the potential and commitment of the candidate to apply the knowledge and skills acquired during the scholarship period to the development of his/her country of origin and the financial need of the candidate. Each essay must contain between 300 and 800 words.

  1. Describe how acquiring this professional development training will directly impact and enhance your professional skills in your current job position.
  1. Please explain how you intend to apply the acquired knowledge and experience in the specific field of study that you will pursue to the development in your country or region.

V. SUPPORTING DOCUMENTS

As indicated in the scholarship announcement, please note that you are required to submit the following documents with this application form:

  • Copy of the transcript of the latest degree obtained
  • Updated resume
  • One letter of recommendation of current or most recent employer
  • Proof of English Proficiency, if not the native language
  • Formal application through the USTTI. Applications may be filed through USTTI’s website:

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