Government of brunei darussalam scholarship for foreign students tenable in brunei darussalam

Please attach passport sized photo here

GOVERNMENT OF BRUNEI DARUSSALAM SCHOLARSHIP FOR FOREIGN STUDENTS TENABLE IN
BRUNEI DARUSSALAM

2022/2023


ACADEMIC SESSION
APPLICATION FORM

	CODE	PROGRAMME NAME	INSTITUTION
FIRST CHOICE				UBD
				KUPU-SB
				UNISSA
				UTB
				PB
SECOND CHOICE				UBD
				KUPU-SB
				UNISSA
				UTB
				PB

INSTRUCTIONS TO APPLICANTS

1. 
   Each applicant must complete this form by typing; handwritten forms are not allowed.
   

2. 
   The following documents MUST be submitted along with this form:
   
   1. 
      Recent passport size photographs.
      
   2. 
      Certified true copies of academic qualifications and other supporting documents (i.e. certificates, testimonials, transcripts).
      
   3. 
      Certified English translations of supporting documents must be submitted for documents that are not in English.
      
   4. 
      Applicant’s Statement of Purpose (Item 6).
      
   5. 
      Certified true copies of Birth Certificate and Passport.
      
   6. 
      Security Vetting from country of origin/residence.
      

PERSONAL AND CONTACT DETAILS (Please use BLOCK Letters)
Name (Please underline surname):
Passport No:	Citizenship:
Date of Birth ( dd/mm/yyyy ):	Country of Birth:
Religion:	Ethnicity:
Marital Status: Single / Married / Divorced / Widowed^*	Gender: Male / Female^*
Postal Address:
Telephone No.:______ - _______ - ____________ ^(country code) (area code) (tel no.) Mobile No.: ________ - _______ - ____________ ^(country code) (area code) (tel no.)	Fax No.: ______ - _______ - ____________ ^(country code) (area code) (tel no.)
E-mail address (if any): (Candidates are strongly advised to provide either an email address or fax number to facilitate correspondence)
Name of Parent/ Guardian/ Next of Kin^*: ______________________________________________________________________________________ Relationship:_______________________________________________________________________ Occupation / Designation: _____________________________________________________________ Address: ______________________________________________________________________________________ ______________________________________________________________________________________ Contact Number/ Email Address: ______________________________________________________________________________________

*delete as appropriate
2. EDUCATION EXPERIENCE (Details of schools attended and academic qualifications)

1. 
   Please state all schools attended from the age of 15
   

Name of School/ Institution	From	To	Qualifications Obtained

2. 
   General Certificate of Education (Ordinary Level or Equivalent)
   

(Please state subjects that you have passed only)

Year	Subjects	Grade	Medium	Examination Body

3. 
   General Certificate of Education (Advanced Level or Equivalent)
   

(Please state subjects that you have passed only)

Year	Subjects	Grade	Medium	Examination Body

4. 
   Other Qualifications (Certificate/ National Certificate/ National Diploma/ Higher National Diploma/ First Degree)
   

Qualifications	Name of Institute & Country	Duration	Date Passed	Classification/ Grade	Medium of Instruction

5. 
   Intended Qualification
   

Name of Programme/ Course	Subjects	Date of Results Expected

3. 
   LANGUAGE PROFICIENCY
   

Language	Written	Reading	Spoken
English	1 2 3	1 2 3	1 2 3
Others, Please State: ………………. ……………….	1 2 3 1 2 3	1 2 3 1 2 3	1 2 3 1 2 3

1: Good 2: Average 3: Poor

4. 
   ACADEMIC DISTINCTIONS OR PRIZES RECEIVED
   

5. 
   PROPOSED FUTURE CAREER
   

6. 
   APPLICANT’S STATEMENT OF PURPOSE
   

In an essay of up to 200 words, describe your plan of study and/ or research you propose to pursue and relate this to your future career plan.

(You may include additional relevant material if there is insufficient space on this form).




Please tick if additional materials are enclosed

7. 
   WORK EXPERIENCE (Please attach additional information if required)
   

Employer’s Name and Address	Position Held	Part-Time/ Full-Time	Dates
			From	To

8. 
   EXTRA CURRICULAR ACTIVITIES
   

(Please attach additional information if required)

Year	Types of Activities (Sports, Cultural, Community Services etc.)	Level of Participation (e.g. Club, District, National, Regional, International etc.)

9. 
   MEMBERSHIP IN ASSOCIATIONS/ PROFESSIONAL BODIES
   

(Please attach additional information if required)

Year