Citadel Capital Scholarship Foundation

Application Form

Insert photo
here.

Personal Information:
1. Full name and Title (Mr., Miss, Mrs.)
__________________________________________________________________
2. Sex:

M___ F___

3. Date of Birth (Day/Month/Year): ___/___/____

4. Marital status: Single ___ Married ___ Divorced ___ Widowed ___
5. Number of dependants (if applicable): _______________________________
6. Do you hold any other nationalities

Yes__

No__

7. If yes, please state: _____________________

Contact Details:
8. Home address:
__________________________________________________________________
__________________________________________________________________

9. Other contact address (if applicable):

_______________________________________________________________
_______________________________________________________________

10. Home telephone: ______________________

11. Mobile number: _______________________
12. E-mail: ________________________
13. Next of kin, name/relation:
_________________________________________/________________________
14. Next of kin address:
_______________________________________________________________
_______________________________________________________________
15. Next of Kin phone number: ______________________
Study Program of Interest:
16. Name of University: ____________________________________________
17. Country: _____________________________________________________
18. Area of Specialization: ___________________________________________
19. Degree objective: MA___ MSc.___ MBA___ PhD (or equivalent)___
20. Have you been officially accepted at your university of choice?
Yes______

No______

21. Have you applied for any other scholarships?

Yes______

No______

22. If yes, please list the scholarships you have applied for and whether or not you
have been accepted:
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________

23. Educational Background:

Name of
School/
University
Secondary

Date
(from/to)

Degree
obtained

Main
Course of
Study

Date
received/
expected

Grade

University

24. Professional Background (starting with the most recent):

Name of
Employer

Position

Duration
(from/to)

Country

25. Are you a member of any NGO or active in any philanthropic or volunteer
initiatives?
Yes___No___
26. If yes, briefly describe the nature of your activities:
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________

27. Statement of purpose:

Please state in no more than 250 words why you wish to pursue your studies in your
chosen field/university and how you believe you can benefit personally and
professionally from your studies in the future.
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________

28. Costs:
List below the total expected costs for 1- tuition 2- living expenses. Please state the
duration of the program of study as well. Attach back-up documents for this
information to your application:
i.

Tuition:___________

ii.

Living Expenses (annual):___________

iii.

Duration of program:___________

Checklist of required documents to be submitted in your file

-

Completed and signed application form for the Citadel Capital Scholarship
Letter of acceptance to ONE university of choice (photocopy)
University application form (if form was submitted online, ask for a pdf
copy from the university) (photocopy)
An updated C.V
Two reference letters (one academic and one professional)
Military service certificate -for males (photocopy)

NOTICE:
Please make sure you do not submit originals where you are required to submit
photocopies. Application packages are not returned to applicants.
If you are shortlisted you will receive a phone call from CCSF during the period
from May 10th - June 10th . If you cannot be reached by phone, CCSF contacts
your next of kin and emails you until you are reached.
Interviews are conducted in person only- during the period from the second
half of May until mid-June.

I certify that the information provided in this application is accurate and complete. I
understand that withholding relevant information requested herein or giving false
information will make me ineligible for the Citadel Capital Scholarship Program and
will result in the cancellation of the scholarship.
Signature:Date:.