Form Beasiswa S1 for UGM
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Transcript of Form Beasiswa S1 for UGM
TOTAL SCHOLARSHIP
Total E&P Indonesie will grant scholarship for 20 students from UI, ITB, UGM, ITS, UPN Veteran Yogyakarta, STT MIGAS Balikpapan & UNMUL with different majors.
This program is considered as one of our commitment to develop human resources by giving a financial support to Indonesian outstanding students.
The scholarship candidates should be in 5th or 7th semester, have good academic records with GPA min. 3.00, and also good English proficiency.
Total E&P Indonesie will conduct selection process together with the University. The grantees will be entitled to receive Rp. 4.000.000,-/ semester for one year.
This form can be returned before 16 May 2015 to TOTALs local university correspondent with the address here below
ECC UGM
Universitas Gadjah Mada
Yogyakarta
For further information, please contact us at : [email protected]
Page 1 of 4
APPLICATION FOR SCHOLARSHIP
PERSONAL DATA
Full Name
:
Present Address
:
Permanent Address
:
Photo
Telephone
:
3x4 cm
E-mail Address
:
Place & Date of Birth
:
Sex
:Male / Female
Account Number
:
Bank Address
:
FAMILY DATA
Name
Age
Education
Occupation
Father
Mother
Sibling:
1
2
3
4
5
EDUCATION BACKGROUND
School
From To
Name & Location of School
Major Course
Graduated/ Degree
GPA
Received
Elementary
Jr. High
Sr. High
University
Page 2 of 4
ORGANIZATIONAL ACTIVITIES
Name of Organization/ Activities
From - To
Position
TRAINING/ COURSE/ APPRENTICESHIP RECORDS
Kind of Training/ Course/
From - To
Organized By
Location
Apprenticeship
ACTIVITIES & HOBBIES
Membership of Professional
Association
Hobbies & Sports
Social Activities
ADDITIONAL INFORMATION (if any)
The facts stated in this Scholarship Form are true and complete to the best of my knowledge and belief.
I understand and agree to follow all the procedures, regulations, and requirements that related to Total E&P Indonesies Scholarship Program.
Date:Applicants Signature:
N.B: Please supply all of this documents, along with this form:
Copy of academic transcripts, from 1st semester until the last semester. 1 photo (3x4 cm).
Copy of the first page of your account book (that stated the Banks name, your name and account number).
Page 3 of 4
Date : _____________________________
Name : _____________________________
1. Why are you entitled to accept this scholarship?
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2. What is your planning after graduated from University?
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Page 4 of 4
