COVID-19 SUPPORT TO GAMBIAN STUDENTS STUDYING IN THE DIASPORA

DATA COLLECTION FORM

to be completed by Gambian students studying under the Jurisdiction of The Gambia Embassy in the United States, Canada, Brazil and
Mexico

Please complete form and Email to: info@gambiaembassydc.org

A. PERSONAL AND CONTACT DETAILS
Name
Surname
Date of Birth
(Indicate here also attach passport copyto this form)
Telephone number
Email
Postal Address

B. UNIVERSITY DETAILS
Name of University / Learning Insitution
Address of University / Learning Institution
Contact of office responsible for International Students (telephone and email)
Student ID number
Full-time student ( Yes or No)
Part-time student ( Yes or No)
Admission Letter (Please attach admission letter from the University / Learning Instution)

C. DETAILS OF STUDIES
Programme of study
Commencement date
Expected year of graduation

D. EMPLOYMENT STATUS
Employment status
Name of institution
Address
Telephone number
Email
Civil/Public Servant (Yes or No)

E. EMPLOYMENT STATUS (In Country of Studies)

Employment Status
Name of Institution /Company
Impact of COVID-19 on current job (Briefly explain)

F. FORM OF SCHOLARSHIP/FUNDING
Fully Funded by the Government of The Gambia
(Provide details)
Partially Funded by the Government of The Gambia (Please specify)
Funded by the Host Country or University (Please specify)
Fully Self-Funded

G. TYPE OF SUPPORT REQUIRED

Do you require support from the Government of The Gambia?
Need support for living expenses Food & or Accommodation (Please specify)
Need support for COVID-19 related to Health issues - (Please specify)
Estimated monthly expenses or accommodation (Provide proof of tenancy)

Footnote ; The Embassy of the Gambia in Washington DC requests all Gambian students, studying in colleges and
universities across the United States, Canada, Brazil and Mexico to clearly and fully complete and immediately
submit the above form as required. This exercise is being undertaken to complement the efforts of the government
on its recently launched Covid-19 Relief package, designed to support the needy Gambians studying in the diaspora
. Therefore, the information being sought will be collated and transmitted to Banjul to assist the relevant authorities
to make informed policy decision on the determination of the appropriate amount of financial resources to be
allocated.

We take this opportunity to once again remind all Gambians residing in the jurisdiction of above mentioned
countries to register with the embassy. Please visit our website on gambiaembassydc.org and register accordingly.
This is critically important especially during emergencies.