WASH Alumni Scholarship Application Form

SCHOLARSHIPS APPLICATION FORM

WASH Alumni Scholarship Application Form

Please complete this form if you are applying for a WASH scholarship within the School of Civil Engineering.

A PERSONAL DETAILS

Title (eg Miss/Mrs/Mr/Dr/Prof) / Family Name (Surname)
Given Names (First Name(s)) / Previous Family Name (if changed)
Gender / Date of Birth
Male / Female / Day / Month / Year
Permanent Home Address / Correspondent Address (if different)
Telephone
Fax
Email / Telephone
Fax
Email
Country of Birth / Nationality

B COURSE/PROGRAMME OF STUDY

In order to be eligible to apply for the scholarship you must have received either a conditional or unconditional offer of a place on the MSc Water, Sanitation and Health Engineering programme of study within the School of Civil Engineering at the University of Leeds.

Application Reference (this is the student registration number that is shown on your offer letter.)
Tick the box to confirm that you have received a conditional or unconditional offer from the University of Leeds.
Year of Entry (in what year will you start the course)
Yes / No
Are you/your family paying for all remaining tuition fees?
Are you/your family paying for all of your living expenses?
If you answered no to either of the two above please give details of where you have secured, or hope to secure, financial assistance from for the remaining amount of fees and living expenses

C SUPPORTING STATEMENT

Please provide below a brief statement which outlines (1) the reason you have chosen to study on the MSc WASH programme (2) your ambitions with respect to work or study after the completion of your MSc and how you see the MSc contributing to that; and (3) an outline of a research question that you would like to focus on during your studies. You should keep your statement brief (not more than 300 words in each section). Please use additional sheets if necessary.

The information provided on this form is accurate and correct

Date / Signature

PLEASE RETURN THE COMPLETED SCHOLARSHIP APPLICATION FORM TO:

SCHOLARSHIP DECISION – OFFICE USE ONLY

Conditional/Unconditional / C / U
Scholarship awarded / Yes / No

If NO please provide details

Candidate Accepted the Scholarship / Yes / No