Al Anani Scholarship Program Stellenbosch University, South Africa. Al Anani Foundation for Human Development

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1 Al Anani Scholarship Program Stellenbosch University, South Africa Sponsored By Al Anani Foundation for Human Development Through Dakahlia Group STUDENT S NAME AS IT APPEARS ON THE PASSPORT First Name Middle Name Family Name Name of University Current Academic Level Date of Application Application Deadline is March 24, P a g e

2 Personal Data First Name Middle Name Last Name National ID Gender Marital Status City: Area of Birth: Country: Country of Permanent legal residence: Citizenship(s): Birth Date: / / City of Birth: Country of Birth: Day Month Year Current Address Address: City: Area of Birth: Country: Home Telephone: Cell Phone: Family Data Father Last Name: First Name: _ Occupation: Telephone: Company\Organization\Ministry: Mother Last Name: First Name: Occupation: Telephone: Company\Organization\Ministry: : 2 P a g e

3 Family Members: Name Age Relationship Grade level Information of a person who can be contacted in case of emergency First Name Middle Name Last Name Address: City: Area of Birth: Country: Home Telephone: Cell Phone: Family member and list all of your family members living at home and their current employment status Name Relationship Status Name Relationship Status Name Relationship Status 3 P a g e

4 Educational Data Secondary School Information Complete/add the information for each high school or secondary school where you attended your first, second, third secondary years and freshman year (sophomore, junior, and senior years in U.S. style high school) School Name: Address: City: Country: Telephone: Type of School: Public Private Graduation Date: Name of government secondary school certificate or high school diploma held or expected to be received.(for example: Baccalaureate, Al-Thanawiyyah Al-Amma, Tawjihi, International Baccalaureate (IB) Name of Certificate/Diploma in English: If Advanced Level GCE, IB, or Advanced Placement, please submit official school transcript to specify subjects passed and grades earned If American Diploma, please click submit official school transcript and SAT score report to specify subjects passed and grades earned University Information Complete/add university information where you are attending your freshman year University Name: Address: City: Country: Telephone: Type of School: Public Private Expected Graduation Date: 4 P a g e

5 Extracurricular, Personal, and Volunteer Activities Interests and Hobbies List all extracurricular activities, all hobbies and any employment or internship opportunities in which you have participated. Please state if you have received any awards, or if you have any outstanding achievements in these activities. Start with the most recent. You can attach a list or summary of your activities on a separate sheet if you like, and please be sure to highlight any leadership roles. Activity Number of Hours per Week Month/Year Started and Ended Name of Award Reason for Receiving Award Date Received Financial Information Have you ever worked? If yes, employment and describe the work, your pay, and the reason for working Job Salary Reason for working 5 P a g e

6 Family Financial Data Please include your family's 2015 household income and household expenses below. Enter amounts per year Income in 2015 U.S. $) Amount (in Father/Guardian (net) (annual wages, salaries, & pensions) Mother/Guardian (net) (annual wages, salaries, & pensions) Your work income Real Estate Holdings Securities (Stocks and Bonds) Other Members of the Household Other (please specify) Total Income: Expense in 2015 Amount (in U.S. $) Yearly household expense (rent, food, clothes, transport etc) Medical Expenses (non-refundable) Taxes Loans or Installments Education tuition for dependents Other expenses If other expenses please specify Total Expenses: Do you have any financial resources that have not been mentioned above? If yes, please describe in detail: 6 P a g e

7 Testing Information Test Name Date Taken Score TOEFL ITP TOEFL ibt IELTS SAT Reasoning Test SAT Subject Test Candidates should take the following subject during their high school or freshman year: - Math; - Science (Physical and Chemistry) - English Languages; and - Two other subjects, from: Biology, Geography, Accounting, History or others. Required Subjects of Study Date Taken Score Mathematics Science (Physical and Chemistry) English Languages Other Subjects Other (specify): Type: Additional Information Where did you hear about the Stellenbosch program? Have you ever participated or applied to other programs? If yes, list and specify these programs: Program Name City/Country Dates From To 7 P a g e

8 Essay: Please submit your essays in a separate sheet. Please keep in mind that the essay will be an essential part of your application. Q1. What is the motive behind studying Agriculture, how through applying to Agriculture program at Stellenbosch University would you be able to achieve success on different levels. Your essay should be 500 typed words. Q2. What is your passion, how have you pursued it, at deeper various levels throughout your life? Your essay should be 350 typed words. 8 P a g e

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