SCHOLARSHIP

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GOVERNMENT OF BRUNEI DARUSSALAM SCHOLARSHIP FOR FOREIGN STUDENTS TENABLE IN
BRUNEI DARUSSALAM
ACADEMIC SESSION
APPLICATION FORM
CODE PROGRAMME NAME
FIRST CHOICE
SECOND CHOICE
INSTRUCTIONS TO APPLICANTS
1. Each applicant must complete this form, to be typed or written legibly.
2. The following documents MUST be submitted with the form:
i. Recent passport size photographs.
ii. Certified true copies of academic qualifications and other supporting documents (i.e. certificates, testimonials, transcripts).
iii. Certified English translations of supporting documents must be submitted for documents that are not in English.
iv. Applicant’s Statement of Purpose (Item 6).
v. Certified true copies of Birth Certificate and Passport.
vi. Security Vetting.
Please attach passport sized photo here
2018/2019
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1. PERSONAL DETAILS (Please use BLOCK Letters)
Name (Please underline surname):
Passport No: Citizenship:
Date of Birth ( dd/mm/yyyy ): Country of Birth:
Religion: Ethnicity:
Marital Status:
Single / Married / Divorced / Widowed*
Gender:
Male / Female*
Postal Address:
Telephone No.:______ - _______ - ____________
(country code) (area code) (tel no.)
Mobile No.: ________ - _______ - ____________
(country code) (area code) (tel no.)
Fax No.: ______ - _______ - ____________
(country code) (area code) (tel no.)
E-mail address (if any):
(Candidates are strongly advised to provide either an email address or a fax number to facilitate
correspondence)
Name of Parent/ Guardian/ Next of Kin*:
______________________________________________________________________________________
Relationship:_______________________________________________________________________
Occupation / Designation: _____________________________________________________________
Address:
______________________________________________________________________________________
______________________________________________________________________________________
Contact Number/ Email Address:
______________________________________________________________________________________
*delete as appropriate
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2. ACADEMIC EXPERIENCE (Details of schools attended and academic qualifications)
A. Please state all schools attended from the age of 15
Name of School/ Institution From To Qualifications Obtained
B. General Certificate of Education (Ordinary Level or Equivalent)
(Please state subjects that you have passed only)
Year Subjects Grade Medium Examination Body
C. General Certificate of Education (Advanced Level or Equivalent)
(Please state subjects that you have passed only)
Year Subjects Grade Medium Examination Body
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D. Other Qualifications (Certificate/ National Certificate/ National Diploma/ Higher National
Diploma/ First Degree)
Qualifications Name of Institute &
Country
Duration Date
Passed
Classification/
Grade
Medium of
Instruction
E. Intended Qualification
Name of Programme/ Course Subjects Date of Results Expected
3. LANGUAGE PROFICIENCY
Language Written Reading Spoken
English
1 2 3
1 2 3
1 2 3
Others, Please State:
i. ……………….
ii. ……………….
1 2 3
1 2 3
1 2 3
1 2 3
1 2 3
1 2 3
1: Good 2: Average 3: Poor
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4. ACADEMIC DISTINCTIONS OR PRIZES RECEIVED
5. PROPOSED FUTURE CAREER
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6. APPLICANT’S STATEMENT OF PURPOSE
In an essay of up to 200 words, describe your plan of study and/ or research you propose to
pursue and relate this to your future career plan.
(You may include additional relevant material if there is insufficient space on this form).
Please tick if additional materials are enclosed
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7. EMPLOYMENT EXPERIENCE (Please attach additional information if required)
Employer’s Name and Address Position Held
Part-Time/
Full-Time
Dates
From To
8. EXTRA CURRICULAR ACTIVITIES AND MEMBERSHIP IN ASSOCIATIONS
(Please attach additional information if required)
Year Types of Activities (Sports, Cultural,
Community Services etc.)
Level of Participation (e.g. Club, District,
National, Regional, International etc.)
9. MEMBERSHIP IN ASSOCIATIONS/ PROFESSIONAL BODIES
(Please attach additional information if required)
Year Associations/ Professional Bodies Position Held
10. ACADEMIC AWARDS/ SCHOLARSHIP ACHIEVED IF ANY
Academic Awards/ Scholarship Institution Name Date Awarded
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11. REFERENCES (Please give details of two (2) people who can act as referees to support
your application. You should contact them yourself and request them to each complete a
“Reference Letter” Form overleaf (C1 or C2) and submit the reference letter accordingly.
Applications cannot be considered unless references are received
Name of Referee Job Title &
Organisation
Telephone &
Fax
E-mail address
12. DECLARATION
I hereby certify that all the statements made on this application and in the attached
documents are true and correct. I have read the general terms and conditions laid down by
the Government of Brunei Darussalam Scholarship for Foreign Students Scholarship Award
for which I now apply. If awarded, I agree to abide by the terms and conditions of the award
and shall return to my home country as soon as I complete my scheduled programme and
will not extend my stay without valid reasons.
Date: …………………….. Signature: ………………………….
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C1
GOVERNMENT OF BRUNEI DARUSSALAM SCHOLARSHIP FOR FOREIGN STUDENTS
‘REFERENCE LETTER’
Assessment on the applicant’s academic ability.
1. Applicant’s Name: ……………………………………………………………………………………
Country: ....................................................................................................................................
Courses Applied: ......................................................................................................................
2. In what capacity do you know the applicant? (e.g. teacher, supervisor, Principal etc.)
…………………………………………………………………………………………………………...
3. How long have you known the applicant? ………………………………………………………….
4. Please evaluate the applicant’s performance by putting an X in the appropriate spaces
below. Extra boxes are available if you wish to add up to three other qualities which you may
find relevant to the assessment of the candidate (E.g. All-round ability, ingenuity,
accountability, manual dexterity etc.)
Assessment on: Excellent Very Good Good Average Below Average
Academic Record
English Proficiency
Creative Thinking
Research Ability
Industry/ Application
Judgement
Independent
Honesty
Motivation
Self Discipline
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5. Is the applicant’s proficiency in English Language (oral and written) adequate to meet
the standard required? Please comment.
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6. Please give your overall assessment on the applicant’s academic ability.
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Referee’s Name: …………………………………………………………………………………………..
Designation: ………………………………………………………………………………………………..
Address: …………………………………………………………………………………………………….
Tel No:………………………… Fax No: ……………………… Email address: ……………………..
Date: ………………………….. Signature: …………………………………………….
THANK YOU FOR YOUR ASSISTANCE. YOU MAY ENCLOSE THE COMPLETED
REFERENCE LETTER IN A SEALED ENVELOPE AND SEND THE COMPLETED FORM TO:
Technical Assistance Unit
Scholarship, Training and Technical Assistance Division,
Department of Administration, Ministry of Foreign Affairs and Trade,
Jalan Subok, Bandar Seri Begawan, BD2710, Brunei Darussalam.
OR E-MAIL/ FAX TO:
E-mail: scholarship@mfa.gov.bn Fax No: (673) 2261250.
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C2
GOVERNMENT OF BRUNEI DARUSSALAM SCHOLARSHIP FOR FOREIGN STUDENTS
‘REFERENCE LETTER’
Assessment on the applicant’s academic ability.
1. Applicant’s Name: ……………………………………………………………………………………
Country: ....................................................................................................................................
Courses Applied: ......................................................................................................................
2. In what capacity do you know the applicant? (e.g. teacher, supervisor, Principal etc.)
…………………………………………………………………………………………………………...
3. How long have you known the applicant? ………………………………………………………….
4. Please evaluate the applicant’s performance by putting an X in the appropriate spaces
below. Extra boxes are available if you wish to add up to three other qualities which you may
find relevant to the assessment of the candidate (E.g. All-round ability, ingenuity,
accountability, manual dexterity etc.)
Assessment on: Excellent Very Good Good Average Below Average
Academic Record
English Proficiency
Creative Thinking
Research Ability
Industry/ Application
Judgement
Independent
Honesty
Motivation
Self Discipline
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5. Is the applicant’s proficiency in English Language (oral and written) adequate to meet the
standard required? Please comment.
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6. Please give your overall assessment on the applicant’s academic ability.
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Referee’s Name: …………………………………………………………………………………………..
Designation: ………………………………………………………………………………………………..
Address: …………………………………………………………………………………………………….
Tel No:………………………… Fax No: ……………………… Email address: ……………………..
Date: ………………………….. Signature: …………………………………………….
THANK YOU FOR YOUR ASSISTANCE. YOU MAY SEND THE COMPLETED FORM TO:
Technical Assistance Unit
Scholarship, Training and Technical Assistance Division,
Department of Administration, Ministry of Foreign Affairs and Trade,
Jalan Subok, Bandar Seri Begawan, BD2710, Brunei Darussalam.
or e-mail/ fax to:
E-mail: applyBDGS2018@mfa.gov.bn Fax No: (673) 2261250.
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(The following endorsement must be completed on the top copy of the application by
the Nominating Agency)
This candidate is nominated for consideration for an award and the following details are
confirmed:
Initials of verifying officer
1. The underlined candidate’s name in Section 1
correctly identifies his or her formal family name.
2. Evidence verified concerning date and place of
birth and nationality.
3. References enclosed from the two (2) persons
named in section 11.
4. Copies of the university or college transcript attached
to the application form.
5. The candidate has sufficient language
proficiency to enable him/ her to profit from his/
her proposed course of study if given in:
(a)
English
(b)
6. The candidate is / is not* in Government employment (*delete appropriately).
TO BE COMPLETED BY THE NOMINATING GOVERNMENT
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17. OFFICIAL DECLARATION (to be completed by the nominating government)
The _________________________________________________________________________________
( Name of Department/ Ministry)
nominates _________________________________________________________________ on behalf of
the Government of ____________________________________ for the Government of Brunei Darussalam
(Country)
Scholarship Award.
__________________________________________ _________________________________________
(Name) (Signature and Ministry’s stamp)
__________________________________________ _________________________________________
(Designation) (Address of Department / Ministry)
___________ - ___________ - _________________
(Country Code) (Area Code) (Office Telephone No.)
___________ - ____________ - __________________
(Country Code) (Area Code) (Office Fax No.)
PLEASE NOTE:
This application form must be duly completed and endorsed by the Ministry of Foreign Affairs or the
relevant agency responsible for the Government of Brunei Darussalam Scholarship in your country.
Please attach relevant supporting documents, which are to be submitted with the form.
INCOMPLETE AND/ OR UNENDORSED FORMS WILL NOT BE PROCESSED.