Office, September–May

Taalstraat 23
NL-5261 BA Vught
The Netherlands
Mobile: +31 - 6 - 22439491
Photo Office, June–August
(passport size) P.O. Box 1972
original picture, S-751 49 Uppsala
face only, must be Sweden
suitable for a student Phone: +46 - 18 - 102370
ID card Fax: +46 - 18 - 121218
Director
Nelleke Dorrestijn
e-mail: director@uiss.org
www.uiss.org
Plusgiro: 695534-8
Bankgiro: 5952-0668

Please print. Send this form together with the regular application form, enclose a statement of
study plans (purpose of Swedish studies), your Curriculum Vitae (resume) and two sealed
letters of recommendation or have them sent directly to the UISS director. Please complete
every item. Incomplete forms will not be taken into consideration. The UISS will not be liable for
original papers sent in support of application. The application for scholarship will be considered
only if all required forms and the $50 or €30 application fee have been sent. This application
needs to be in our possession by March 15, 2011.

I wish to attend the … week session, date……………………………2011

____________________________ _________________________ ________________________

Family name First Name Marital status

________________________________________________________ ________________________
Street Postal code

________________________________________________________ ________________________
State City Country

Are you applying for any other scholarships for this course? ❑ Yes ❑ No
If yes to whom?
_______________________________________________________________________

EDUCATION. Specify the degrees, diplomas or other educational documents you hold.
SCHOOL SUBJECT GRADE OR CREDIT OBTAINED YEAR

PRESENT OCCUPATION. If you are now pursuing studies, state the subject, the degree you are
working for, and the date when you expect to take the final examination.

______________________________________________________________________________________

______________________________________________________________________________________

______________________________________________________________________________________
OTHER QUALIFICATIONS. Do you have any practical experience in your field; taken part in
student activities or others of similar nature; issued any publications; previously received
scholarship?

______________________________________________________________________________________

______________________________________________________________________________________

PREVIOUS VISITS TO SWEDEN. Place, purpose and length of visit.

______________________________________________________________________________________

______________________________________________________________________________________

______________________________________________________________________________________

REFERENCES. Name two persons whom you have asked to send written references directly to
the UISS. These persons should represent an official institution, e.g. university, employer. The
reference letters should include data about your academic achievements, how the study of the
Swedish language is important for your career or studies and whether you need a partial or a full
scholarship.

________________________ _________________________________________________________
Title or position Name

______________________________________________________________________________________
Address

________________________ _________________________________________________________
Title or position Name

______________________________________________________________________________________
Address

PLEASE NOTE: The maximum value of a scholarship for two weeks is 10.700 SEK, for four, six
and eight weeks it is 19.800 SEK i.e. the fee of the 4 week session. Partial scholarships may only
be deducted from the UISS fees. Applicants for a full scholarship need not pay the advance
payment of 5.000 SEK. See for detailed information the brochure 'Summer Studies'.

YOUR ESTIMATED BUDGET FOR THE SUMMER SESSION: Please write a statement of your
financial situation and needs. Use an extra sheet of paper if necessary. There are no travel grants,
grants for living expenses or grants for the Lapland/Finland/Värmland trip. Do not apply for a full
scholarship if you can do with a partial one. The UISS has very limited funds.

______________________________________________________________________________________

______________________________________________________________________________________

______________________________________________________________________________________

______________________________________________________________________________________

MINIMUM FINANCIAL AID NEEDED SEK _______________

(must not exceed the maximum value as stated above). If you cannot find the rate of exchange of
Swedish kronor as compared to your own currency, enter the amount in your currency or in Euro or
American dollars.

I hereby certify that the statements in this application are true.

_______________________ _________________________ _____________________________

Place Date Signature