Warwick Graduates’ Association Hong Kong 2011Scholarship

Application Form

Scholarship for students commencing undergraduate studies at the University of Warwick

Applicants should read carefully the scholarship guidelines on eligibility before completing this form. It is the applicant’s responsibility to ensure that the application and supporting documentation reach the WGAHK Office by the deadline. Please ensure all relevant questions are answered as only complete applications will be considered.

Applications Closing Date: Wednesday 31st August 2011(Date as post mark, or date and time as 11:59PM HKT as shown on the email upon receipt)

Return address: Suite 908, 9/F, Great Eagle Centre, 23 Harbour Road, Wanchai, Hong Kong

SECTION A (APPLICANTS TO COMPLETE)

WGAHK Scholarship (open to all students)
WGAHK Engineering Scholarship (for Engineering courses only)[1] [see footnote below]

Please tick where appropriate

  1. Your name:

Surname: / First Name: / Sex:
Male / Female
  1. Your date of birth (Date / Month / Year):

Age:
  1. Your permanent home address:
  1. Your contact details in August to September 2011:

Tel (Home): / Tel (Mobile):
E-mail address:
  1. The Warwick undergraduate course of which you have been offereda place for 2011 entry:

Course Name: / Point of Entry:
Year 1 or 2
  1. Your UCAS number:
  1. Previous secondary school / college / universityattended (starting with the most recent institution):

Year / Institution
  1. Academic Qualifications (please provide all the relevant exam results):

Level / Course / Subjects studied / Grades / Qualifications awarded
GCSE / HKCEE / IGCSE or equivalent
GCE A-level / HKAL
/International Baccalaureate or equivalent
Foundation Programme /
Higher Diploma /
University Degree
  1. State other Academic or English Language Qualifications, if any:

Name of Test / Score / Year obtained
  1. State your Work Experience, if any:

Dates (From / To) / Position / Nature of Work / Name of Employer
AWARDS AND EXTRA-CURRICULAR ACTIVITIES
  1. List out,in bullet-points form,the extra-curricular activities you have been involved in,e.g. Sports, Inter-School events, Social Services or Cultural Activities
  1. List out,in bullet-points form, the awards or certificates you have received, if any.

  1. STATEMENT OF INTEREST

For All Applicants:Please supply a personal statement (maximum 300 words) in support of your application. Tell us, for example, about your leadership experience, your career aspirations, and what you expect to achieve from your Warwick undergraduate course.

Extra requirements For WGAHK Engineering Scholarship applicants:Please further tell us a memorable experience when you worked on a school science project, andindicate why you are interested in Engineering studies.

DECLARATION

I acknowledge and agree that the personal data provided by means of this application will be used for activities relating to the processing of my application for an award of the scholarship. I declare that I have read and understood the eligibility and selection criteria as outlined in the WGAHK scholarship package and that the information I have supplied on this form is, to the best of my knowledge, complete and correct. I acknowledge that the WGAHK may withdraw a scholarship offer or terminate my scholarship if I have misrepresented my past and/or present circumstances and that this termination may take place at any stage during the tertiary course.

Signature of applicant: ______Date:______

SECTION B(REFERENCE)

Warwick Graduates’ Association Hong Kong 2011 Scholarship

Note to referee:Please refer to the Information relating to Section B (Reference) available on our website: All comments collected in this section will only be used in the selection process of WGAHK Scholarship.

Applications Closing Date: 31st August 2011 (Please observe the applications closing date carefully as the screening process will soon take place after the said date.)

Please send this reference by email to OR by fax to (+852) 2845 3003 OR by post to: WGAHK, Suite 908, 9/F, Great Eagle Centre, 23 Harbour Road, Wanchai, Hong Kong

Name of Applicant: ______UCAS# (if known)______

Details of Referee:

Name:
School / Institution:
Title / Position:
Address:
Phone: / E-mail:

The information provided above is to the best of my knowledge and is fair and accurate.

Signature of Referee:______Date:______

1

Warwick Graduates’ Association (Hong Kong) 2011 Scholarship

[1]Note to Engineering students: You are eligible to apply for both scholarships by ticking two boxes. Please refer to Guideline to Applicants for eligibility.