Scholarship Application

For spring semester 2018

New Applicants and Applicants Renewing Scholarships
Please provide all the required information as listed in this form. You can type your
responses independently of this form but your information should follow this format and
responses should correspond to the numbered system below. All applicants should fill out
sections A and B. New applicants who are not currently recipients of a Studenica scholarhip
should also fill out section C. Students who are currently recipients of a Studenica
scholarship and are applying to continue to receive Studenica scholarships should also fill
out section D.

A. PERSONAL DATA
1) Name:
______________________________________________________________________________
First Middle Last

2) Gender: Female _____ Male______

3) Date of birth _____________ 4) Place of birth: ________________

5) Citizenship: (Check One)

B&H _____ Croatia _____ Macedonia _____ Montenegro _____ Serbia _____ Slovenia _____

6) Permanent address
________________________________________________________________________________
Number, street, apartment number Postal code City Country

7) Address in school:
________________________________________________________________________________
Number, street, apartment number Postal code City Country

8) Email address: _________________________ 9) Telephone: ___________________________

B. EDUCATIONAL INFORMATION

10) Name of University you are attending:

__________________________________________________________

11) Address:
________________________________________________________________________________
Number, street, apartment number Postal code City Country
12) Current year of study? III ___ IV ___ 13) Date enrolled: ____________

14) Graduation date: ______________

15) Student ID Number _________ 16) Overall grade average: __________

17) Have you previously received a Studenica Foundation scholarship?

Yes ____ Date _________, No_______

C. ADDITIONAL INFORMATION For New Applicants Only

18) Other evidence of high-level performance (e.g. merit scholarships, academic prizes, research
results, artistic creations, publications, winners of competitions)

List all university level institutions attended and include summer, study abroad, exchange
programs and specify beginning and ending dates of attendance.
Institution _______________________________________________
DATE: From Month _____ Year______ To Month ____ Year_____
Institution _______________________________________________
DATE: From Month _____ Year______ To Month ____ Year_____
Institution _______________________________________________
DATE: From Month _____ Year______ To Month ____ Year_____
Institution _______________________________________________
DATE: From Month _____ Year______ To Month ____ Year_____
Institution _______________________________________________
DATE: From Month _____ Year______ To Month ____ Year_____

List up to 10 most important university activities you participated in (student government,

sports, publications, school-sponsored service programs, student-faculty committees, arts,
music, etc. List in descending order of significance and specify dates.
Activity _______________ Your Role ____________
Dates: From____________ To_____________
Activity _______________ Your Role ____________
Dates: From____________ To_____________
Activity _______________ Your Role ____________
Dates: From____________ To_____________
Activity _______________ Your Role ____________
Dates: From____________ To_____________
Activity _______________ Your Role ____________
Dates: From____________ To_____________
 List up to 10 most important public service and community activities (refugee programs,
environmental protection/conservation, advocacy, religious organizations, etc.) Do not repeat
items listed previously. Include dates.
Activity _______________ Your Role ____________
Dates: From____________ To_____________
Activity _______________ Your Role ____________
Dates: From____________ To_____________
Activity _______________ Your Role ____________
Dates: From____________ To_____________
Activity _______________ Your Role ____________
Dates: From____________ To_____________
Activity _______________ Your Role ____________
Dates: From____________ To_____________

List all government activities (internships with government agencies, partisan political
activities, commissions, etc. Include dates.
Activity _______________ Your Role ____________
Dates: From____________ To_____________
Activity _______________ Your Role ____________
Dates: From____________ To_____________
Activity _______________ Your Role ____________
Dates: From____________ To_____________
Activity _______________ Your Role ____________
Dates: From____________ To_____________
Activity _______________ Your Role ____________
Dates: From____________ To_____________

List part time and full-time jobs and internships, current and during university studies
name of organization/business, your function, dates.
Organization/Business Name _________________________
Location _________________________
Job/Internship Function ________________________
Dates: From____________ To_____________
Contact: Name _____________________
Phone ________________ E-mail ______________________

Organization/Business Name _________________________

Location _________________________
Job/Internship Function ________________________
Dates: From____________ To_____________
Contact: Name _____________________
Phone ________________ E-mail ______________________
 Organization/Business Name _________________________
Location _________________________
Job/Internship Function ________________________
Dates: From____________ To_____________
Contact: Name _____________________
Phone ________________ E-mail ______________________

List awards, special recognitions you have received or publications of your writing and any
conferences, symposiums you participated in as a presenter and dates.
Awards /Recognitions
Title or name of award _______________________
From Institution ___________________ Date _____
Title or name of award _______________________
From Institution ___________________ Date _____
Title or name of award _______________________
From Institution ___________________ Date _____

Publications

Title _____________________________ Where it appeared ________________________

Date _____
Title _____________________________ Where it appeared ________________________
Date _____
Title _____________________________ Where it appeared ________________________
Date _____

Conference/Symposium

Name ________________________________ Location ___________________________

Date _____ Title of Your Presentation ___________________________________________

Name ________________________________ Location ___________________________

Date _____ Title of Your Presentation ___________________________________________

Name ________________________________ Location ___________________________

Date _____ Title of Your Presentation ___________________________________________
 List any other scholarships you are receiving for the semester for which you are applying
Scholarship Amount _____________
From Source __________________________________________
Scholarship Amount _____________
From Source __________________________________________
Scholarship Amount _____________
From Source __________________________________________

20) List additional capabilities

Check any foreign languages you speak and the level of fluency (fluent, conversational,
minimal)
English ______
Fluency level: Fluent ____ Conversational ____ Reading only _____ Minimal _____
French ______
Fluency level: Fluent ____ Conversational ____ Reading only _____ Minimal _____
German ______
Fluency level: Fluent ____ Conversational ____ Reading only _____ Minimal _____
Russian ______
Fluency level: Fluent ____ Conversational ____ Reading only _____ Minimal _____
Other________
Fluency level: Fluent ____ Conversational ____ Reading only _____ Minimal _____

Conputer literacy
Word___ Excel ____ Power Point ____ Database management ____
Facebook ____ LinkedIn ____ Twitter ____
Other social networks (specify which) ___________________
Programming ____ Programming language ________________
Other _____________________________________________________________________

Other capabilities
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________

20) Describe your financial situation and reasons you need financial assistance
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________

22) Provide letters of recommendation from two people who know you and your work. The letters
should cite specific examples of your leadership, character, performance, commitment and
initiative. List below the names, titles and your relationship to the people who are writing letters of
recommendation.
Name ________________________________
Institution ________________________________________
Title _________________________________
Your Relationship __________________________________
Name ________________________________
Institution ________________________________________
Title _________________________________
Your Relationship __________________________________

23) Please write an essay not to exceed 300 words and discuss:
 Your educational and career goals
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________

Why do you think you are a good candidate for a Studenica Foundation scholarship?
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________

How would you contribute to Studenica Foundation if you were to receive a scholarship?
Specifically:
How would you help enhance the Homeland/Diaspora relationship?
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________

How would you engage in the Studenica Scholarship Recipient Alumni Association?
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________

How much time/week and in what way could you contribute by volunteering your time and
talent?
Time per week _______________
What would you do? ____________________________________

Other comments you would like to add that you think will help the Studenica Foundation
understand better why you should be a scholarship recipient?
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________

D. ADDITIONAL INFORMATION
For Applicants Renewing Studenica Scholarships

24) Check the school year you received a Studenica Scholarship?

2015/2016 ___ 2016/2017 ___ Other _______

25) List all your accomplishments (awards, publications, etc.) and most significant academic
achievements in the previous year.

Award/Publication name _________________________

From Institution _____________________________

Award/Publication name _________________________

From Institution _____________________________
 Award/Publication name _________________________
From Institution _____________________________

26) How did you contribute to Studenica Foundation while you were a recipient of a Studenica
scholarship?
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________

27) How would you contribute to Studenica Foundation if you were to receive a scholarship?
Specifically:
How would you help enhance the Homeland/Diaspora relationship?
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________

How would you engage in the Studenica Scholarship Recipient Alumni Association?
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________

How much time/week and in what way could you contribute by volunteering your time and
talent?
Time per week _______________
What would you do? _______________________________________

Other comments you would like to add that you think will help the Studenica Foundation
understand better why you should be a scholarship recipient?
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________