NamPower Bursary Scheme APPLICATION FORM FOR BURSARY CLOSING DATE FOR APPLICATIONS: 31 OCTOBER 2017 For office use: Study field Points Gr 10 Points Gr 12 Please return the application form to: The Bursary Administrator PO Box 2864 Windhoek, Namibia Passport Photo If you have not received feedback or correspondence relating to this application from NamPower by 31 December of the year of application, you can assume that your application has been unsuccessful. SECTION A APPLICATION DETAILS (Please print or type clearly) FIELDS OF STUDY (as advertised) A. UNDERGRADUATE BURSARIES Degree in Electro-Mechanical Engineering Degree in Mechatronic Engineering Degree in Electrical/Power Engineering National Diploma in Vocational Training (Electrical General) National Diploma in Vocational Training (Mechanical Fitting & Turning) Degree in Education (Majoring in Maths & Science) B. POSTGRADUATE BURSARIES Masters in Electrical/Electronic Engineering Masters in Information Technology (Specializing in Security) 1 P a g e
C. BURSARIES FOR PEOPLE WITH DISABILITIES (Undergraduate Degree/Diplomas) Special Education (Master Degree in Special Education) Degree in Accounting Degree in Business Administration Surname: SECTION B PERSONAL PARTICULARS Surname: First name(s): Postal address: (at home) Telephone number: (home) (work/school) Citizenship: Date of birth: ID or passport number: Sex: Marital status: Do you have a disability / disabilities? Particulars of parent / guardian (please indicate the relationship) Surname: First name(s): Residential address: Postal address: Telephone number: (home) (work) Occupation of parent / guardian: Name and address of employer: Number of dependents of yourself / your parents or guardian: 2 P a g e
Name: Age:. SECTION C: CAREER AND EDUCATION CAREER AMBITIONS State the career you wish to follow: Name of the degree or diploma you intend to study: Study year for which you will be registered next year: (e.g. First, second) Name of proposed university/ technikon: What are your plans? (After completion of your studies) EDUCATIONAL QUALIFICATIONS 1.1 School leaving certificate (e.g. IGSCE, Matric, etc.) (i) (ii) (iii) (iv) Name of school and town: Region: Year examination is written / to be written: Subjects and symbols obtained in the last written examination: Please state your results for grade 10 and 12: 3 P a g e
GRADE 10 SUBJECTS PASSED: (State year in which passed submit written proof) SUBJECTS 1. GRADE 10 December Results 2. 3. 4. 5. 6. 7. 8. AGGREGATE GRADE 12 SUBJECTS PASSED (State year in which passed and submit written proof) SUBJECTS HIGSCE / IGCSE GRADE 12 April Results 1 2 3 4 5 6 7 8 AGGREGATE Grade 12 August Results (if available) Grade 12 December Results (if available) 1.2 Tertiary Training (i) Degrees or diplomas already obtained: Please list the major subjects and the year in which you obtained these qualifications: 4 P a g e
(ii) Degree or diploma that you intend to register for: (iii) Duration of the course: years (iv) What will your major subjects be when doing your degree or diploma? (v) At which university or technikon do you want to study? (vi) Where are you going to stay while you are studying? 1.3 Present Studies Course and year of study: Subjects successfully completed: SUBJECTS NB: ATTACH PROOF OF RESULTS. Please furnish details if you are repeating any subjects 5 P a g e
2. WHAT HAVE YOU BEEN DOING SINCE YOU LEFT SCHOOL? This section is only applicable to those who have already completed school. Year: Details: 3. IF YOU HAVE APPLIED FOR OTHER BURSARIES OR SCHOLARSHIPS, PLEASE LIST: Amount: Name of Donor: Granted: (Yes/No) Obligations: 4. WHAT ARE YOUR PLANS? (After completion of your studies) 4.1 What type of work would you like to do? 4.2 Would you like to go for further studies after completing this degree/diploma? 4.3 Tell us about yourself: (Any information not given in previous questions) 6 P a g e
5. PLEASE SUBMIT THE FOLLOWING DOCUMENTS WITH YOUR APPLICATION FORM 5.1 Certified copies of your April and August grade 12 examination results. Students at university or technikon must submit copies of their latest results 5.2 One passport photograph 5.3 A certified conduct (testimonial from the school principal). 5.4 Certified copy of birth certificate / passport 5.5 Proof of provisional acceptance from university / technikon if it is available. FAILURE TO COMPLETE THE APPLICATION FORM TRUTHFULLY, MAY LEAD TO THE WITHDRAWAL OF THE BURSARY. UNDERTAKING I, (Full name and surname in capital letters) Of (Address) Certify that the information supplied by me in the sections above are true, complete and correct to the best of my knowledge. Signature of Applicant: Signature of Parent/ Guardian: (Only necessary if applicant is under the age of 21) Date: PLEASE NOTE: INCOMPLETE APPLICATION FORMS WILL NOT BE PROCESSED. 7 P a g e