Empower Scholarship Application Academic Year

Transcription

1 Empower Scholarship Application Academic Year Personal Data Name: Address: City/Markaz: District/Sub-district: Governorate: Landline Number: Date and Place of Birth: National ID Number: P.O. Box: Nationality: Passport Number, if any: Do you suffer from any chronic disease(s)? If, please explain. Number of Brothers: Number of Sisters: Sex: Female Male Emergency Contact Name: Degree of Kinship: Emergency Contact Number: 2. Family Data Father s Name: Occupation: Organization/Company: Work Address: Office Phone Number: Mother s Name: Occupation: Organization/Company: Work Address: Office Phone Number: 1

2 3. Education a. Basic and Secondary Education: Preparatory School: Secondary School: Section Science Arts Second Secondary Grade (Percentage): Grade in English Language: Which major or discipline would you like to study at AUC? Have you completed an English test in the period from September 2016 to present? If, specify: TOEFL (ibt or ITP), IELTS or any other tests. Test Name Test Date Test Score 4. Hobbies, Extracurricular and Voluntary Activities Mention all extra-curricular activities, hobbies or voluntary activities you have participated in; as well as any awarded prizes or certificates; or any outstanding accomplishments. Start with the most recent activities. If need arises for an additional sheet, please attach it to the application form. Activities/ Awarded Prize (if any) Number of years practicing this activity When did you start practicing this activity? Average number of participation hours per week Why were you awarded the prize? When were you awarded the prize? 5. Explain why you are interested in the EMPOWER Scholarship Program? What are you expecting from the program? 2

3 6. In no more than 300 words, write about a critical issue/problem affecting any of the population sectors in your governorate. Analyze the causes of this problem, and provide your insight on how to solve this problem. Please write the essay on a separate sheet of paper in clear handwriting or provide a printed copy, and attach it to this form. 7. Have you ever joined a cultural exchange program? If the answer is, please indicate the program s name and year. Please attach the program certificate. 8. How did you learn about the program? Friends NGOs Social Networks School Newspaper or Magazine Advertisements Television or Radio Information Seminars Other 9. Do you have any relatives who graduated from, or are currently enrolled at AUC? If the answer is, please explain: 3

4 Full Name Degree of Kinship GPA Graduation Year 10. Do you wish to join the program through full or partial funding? Full Partial 11. Acknowledgment I hereby acknowledge that I have personally completed this form without any assistance. I confirm that all the information presented herein is valid and real. I am also aware that AUC staff is entitled to validate all the information set forth in the form and the annexed certificates and that any incorrect or incomplete information may result in exclusion from the scholarship pool of candidates or dismissal from the Empower Program. Applicant s Signature in English and Arabic Guardian s Signature in English and Arabic For Office Use Only: Reviewer s Signature: Required Certificates/Documents *To confirm attachment of the required papers, please insert a tick in the box opposite the document: EMPOWER Scholarship Program Application Form from the website ( AUC Financial Aid form Copy of birth certificate Letter from the respective Department of Education (Idarah Taalimiya) on the type of school where the applicant is enrolled (public, private, experimental or language school). Official excerpt of the third secondary grades once the thanawiya amma results are announced. Copies of certificates for extra-curricular activities. IELTS test results. Copies of third preparatory, first and second secondary certificates. Deadline for submission of required documents June 7,

5 Please send required documents using registered mail with acknowledged receipt or by hand to the following address: The American University in Cairo (Office of Student Financial Affairs and Scholarships - Campus Center P024) AUC New Cairo AUC Avenue P.O. Box 74 New Cairo For inquiries, call fscholarship@aucegypt.edu * Please note that the program administration will contact only those nominated for the personal interview in July