www.nesovietnam.org

Saigon Tower, 29 Le Duan, Suite 901, Ho Chi Minh city, Vietnam

Tel: +84 (8) 3823 7174

Orange Tulip Scholarship (OTS) Vietnam

Academic year 2017-2018

Application Form

1.  PERSONAL INFORMATION
Full name / Click here to enter text. / ☐ Male ☐ Female
Address / Click here to enter text.
City & postcode / Click here to enter text. / Click here to enter text.
E-mail / Click here to enter text.
Mobile phone & telephone / Click here to enter text. / Click here to enter text.
Birthday (dd/mm/yyyy) / Click here to enter text.
Birthplace / Click here to enter text.
Nationality / Click here to enter text.
2.  STUDY PROGRAMME IN THE NETHERLANDS
Current application status / ☐ I am currently applying to one of the eligible programmes
Study programme: Click here to enter text.
Institution: Click here to enter text.
☐ I have been accepted by the eligible Dutch institution in one of the eligible study
programmes
Study programme: Click here to enter text.
Institution: Click here to enter text.
(See list of eligible programmes and participating institutions at www.nesovietnam.org)
Are you also applying to other institutions under the Orange Tulip Scholarship? / ☐ No
☐ Yes (please specify below)
Institution / Study programme
Click here to enter text. / Click here to enter text.
Click here to enter text. / Click here to enter text.
Click here to enter text. / Click here to enter text.
Click here to enter text. / Click here to enter text.
You can apply to more than one OTS schemes. For each scheme, a separate OTS application form needs to be submitted.
3.  ADDITIONAL OTS VIETNAM SCHEMES
If you would like to be considered for additional schemes, please write the additional scheme(s) that you are interested in.
IMPORTANT: Please regularly check the offered additional schemes and the requirements at https://goo.gl/Hi3SNA
☐ Additional scheme 1: Click here to enter text.
☐ Additional scheme 2: Click here to enter text.
☐ Additional scheme 3: Click here to enter text.
4.  ACADEMIC BACKGROUND
Name of last/current education institution / Click here to enter text.
City & country / Click here to enter text. / Click here to enter text.
Study programme / Click here to enter text.
Level of degree (to be) obtained / ☐ High school / ☐ Bachelor / ☐ Master / ☐ PhD
(Expected) month & year of graduation (mm/yyyy) / Click here to enter text.
GPA / out of
English exam score month + year taken / ☐ IELTS (month+year): Click here to enter text. / ☐ iBT (month+year): Click here to enter text. / ☐ I have not taken an exam yet
GRE test result (if applicable) / Click here to enter text. / Month & year taken: Click here to enter text.
GMAT test result (if applicable) / Click here to enter text. / Month & year taken: Click here to enter text.
5.  WORKING EXPERIENCE
Current or last working experience (If applicable). Please include your curriculum vitae on a separate file
Company/ organization: Click here to enter text.
Job position: Click here to enter text.
Short job description (max. 2 lines): Click here to enter text.
Other working experience(s) (max. 2 lines): Click here to enter text.
6.  FINANCING YOUR STUDIES
How do you plan to finance your studies at the Dutch higher education institutions (multiple answers possible)?
☐ My own savings ☐ Bank credit/loan
☐ Parents or family ☐ Scholarship(s)
☐ Employer ☐ Other: Click here to enter text.
Please specify other scholarships that you are applying to:
Click here to enter text.
7.  CHECK REQUIRED DOCUMENTS
Please check the required documents of each scheme at www.nesovietnam.org
Please send the required documents to Nuffic Neso Vietnam : softcopy to before 1 April 2017 (unless the institution for which you are applying mentions a different deadline on the Orange Tulip Scholarship website). Incomplete forms and packages will not be taken into account.
PLEASE NOTE THAT EACH ORANGE TULIP SCHOLARSHIP SPONSOR MAY REQUIRE ADDITIONAL DOCUMENTATION. PLEASE READ CAREFULLY THE INFORMATION ON THE NUFFIC NESO VIETNAM – ORANGE TULIP SCHOLARSHIP WEBPAGE
All data will be treated strictly confidential by Nuffic Neso Vietnam and the selected Dutch higher education institutions, solely for the purpose of the Orange Tulip Scholarship Vietnam programme application.

I certify that the information I have provided in this form is true, complete and correct.

Place : Click here to enter text.

Date : Click here to enter text.

Name : Click here to enter text.

Signature :

Orange Tulip Scholarship Vietnam 2015-2016 Application Form

© 20/10/2014