Professional Documents
Culture Documents
Wells Mountain Foundation, Inc. 25 D Main Street Bristol, Vermont 05443 USA Or wmfscholars@wellsmountainfoundation.org
Family Name: __________________________________________ Given Name: __________________________________________ What do you like to be called: ______________________________
Address: ___________________________________________________________________ City: _______________Region/State/Province: ________________Country: ______________ Telephone: _____________________ Mobile Telephone: __________________________
Page - 2 Name, Address, Telephone Number, and E-mail Address of the closest living relative (i.e. mother, father, spouse, grandparents, uncle, aunt, etc): _______________________________
______________________________________________________________________________
Where do you plan to study name of school and location (city and country)?
______________________________________________________________________________
Total duration of the program through a degree or certification? _________________________ Have you been accepted to this program yet? _________ If no, when do you expect to receive a letter of acceptance? ___________________________ If you are just beginning this program, what date will your studies begin? __________________ If you are in this program and attending classes, how many years have you finished? ________ What month and year do you expect to graduate? ____________________________________ How many total years will you be in the program?_____________________________________
Page - 3 What is your best estimate of the costs for your program for one school year? Please do not over-estimate your financial costs. Local currency Tuition: School fees: Cost of room: Supplies: Other: (please specify) _______________ _______________ Total: ______________ ______________ ______________ ______________ ______________ ______________ ______________ ______________ U.S. Dollars
(Be sure to convert the costs)
About You:
Please list and describe prior educational experience including schools you have attended and graduated from, and the course of study. Do not include primary schools. ____________________________________________________________________________ ____________________________________________________________________________ Please list and describe all employment experiences: ____________________________________________________________________________ ____________________________________________________________________________ Please list any volunteer activities that you have been involved in. ___________________________________________________________________________ ___________________________________________________________________________ Tell us what you plan to do after you complete your education including where you hope to live? ____________________________________________________________________________ ____________________________________________________________________________
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Documents that you must include with your application: Please check off these items to be sure you have included them. We will not consider incomplete applications!!
A brochure or other information on the educational institution that you propose to attend. Do not just give us the schools website, although you may print out info from the site and included it with your application. We have some brochures on file in our office. If you plan to attend any of the following, it is not necessary to send a brochure: Kampala International U., Port Harcourt U., Aga Khan U., Bugema U., Takoradi Poly, Niger Delta U., U. of Cape Coast, Kwame Nkrumah U., Haramaya U., U. of Ghana, Makerere U., and Gulu U., as we have copies of their catalogs on file in our office. A letter of acceptance from the school, if you have already received one. If not, send it to us once you have been accepted, noting that you have already sent in an application. Two letters of recommendation from people who know you, but are not family members, such as employers, teachers, clergy, volunteer group leaders, etc., who can tell us about your character and abilities. A personal statement of at least 500 words, telling us about your background, your family, your life experiences, why you chose to study the particular field you are studying, and why you believe you should be favorably considered for this scholarship. This statement is a very important part of our decision making process! Official transcript of grades from secondary school with a key to interpreting the grades. For example, in some countries D means below average and in others it stands for Distinction. If you have already completed one or more years at the tertiary level, please include an official grade report for these studies. Do not include grades from primary or junior high school. Results from your national exam, if your country gives this kind of student examination. Please only send in your application once. We will send you an email acknowledgement when it arrives in our office. If you do not receive an acknowledgement after two weeks, email us and ask if we have received it before you send another copy.
Volunteer Service
The Wells Mountain Foundation is committed to the importance of volunteer service. We believe volunteer service provides benefits not only to the cause where the time is expended, but also to the volunteer. Applicants for a scholarship should be advised that an award of a scholarship will come with a requirement for some period of volunteer activity by the scholarship recipient at a non-profit organization or school in your country or near your school. I hereby certify that all of the information provided here and in the attached documents is accurate and that this application is complete. ________________________________________ _________________________
Date
442069