application form - Commonwealth Scholarship Commission in the ...

COMMONWEALTH RESIDENTIAL SCHOOL: The World in 2113
8-12 August 2013, Cumberland Lodge, Windsor Great Park, United Kingdom
COMMONWEALTH SCHOLARS BURSARY APPLICATION FORM
1.a) TITLE (delete as applicable)
1.b) FULL NAME (underline surname)
2. PERMANENT ADDRESS
3. ADDRESS FOR CORRESPONDENCE (if different from above)
4. EMAIL ADDRESS
5. TELEPHONE NUMBER ╪
6. FAX NUMBER ╪
7. DATE OF BIRTH
8. NATIONALITY(IES)
9. CURRENT COURSE AND YEAR OF STUDY*
10. CURRENT UNIVERSITY**
* Applicants should be engaged in a course of study at an ACU member university. At the time of
application, they should either be studying for a postgraduate degree (full- or part- time) OR in the
final year of an undergraduate degree, with the expectation of moving to postgraduate study on
completion.
** A list of universities that are members of the ACU can be found at
www.acu.ac.uk/membership/acu-members
╪
Optional

11.a) ACADEMIC RECORD in chronological order
From To School/college/university
Qualifications (including course
title and subjects studied)
11.b) EMPLOYMENT RECORD in chronological order (if any)
From To Organisation Main role(s) and activities
11.c) PUBLICATIONS in print, digital or multimedia (if any)
12. CURRENT OR PREVIOUS MEMBERSHIP OF OR INVOLVEMENT IN SOCIAL, CULTURAL,
POLITICAL, COMMONWEALTH OR OTHER INTERNATIONAL ORGANISATIONS (if any)
13. ANY OTHER ACTIVITIES THAT YOU WOULD LIKE TO MENTION

14. HAVE YOU STUDIED, WORKED, OR UNDERTAKEN ANY VISIT LONGER THAN
FOURTEEN DAYS OUTSIDE YOUR HOME REGION BEFORE? (Please see section at the end
of this form for definition of regions)
If YES, please give details (maximum 100 words)
15. WHY WOULD YOU LIKE TO ATTEND THE COMMONWEALTH RESIDENTIAL SCHOOL?
WHAT DO YOU FEEL YOU WOULD CONTRIBUTE? (maximum 100 words)

16. THE THEME OF THIS YEAR’S COMMONWEALTH RESIDENTIAL SCHOOL IS ‘THE
WORLD IN 2113’. PLEASE WRITE A SHORT CREATIVE STATEMENT (no more than 300
words) ON HOW YOU FEEL THE WORLD WILL CHANGE IN THE NEXT CENTURY IN ANY
AREA OF YOUR CHOICE.

16. BURSARY APPLICATION
The CSC is making available a number of bursaries for Commonwealth Scholars, covering costs of
attendance at the school (accommodation, meals, and registration fees) and travel to the venue
from within the UK.
PLEASE TICK THE APPROPRIATE BOX BELOW:
I WISH TO APPLY FOR A COMMONWEALTH SCHOLARS BURSARY
NO BURSARY REQUIRED – I WILL COVER ALL THE COSTS OF ATTENDING MYSELF
17. REFEREE
Name the person you are asking to supply a confidential reference about you. This person
should be familiar with your recent academic work.
NAME
ADDRESS
POSITION
EMAIL
ADDRESS
18. DECLARATION BY APPLICANT
I declare that the statements made in this application are, to the best of my belief, true,
complete and correct.
SIGNATURE
DATE
Please return this form when complete to:
Joanne Hyde
Student Engagement Officer
Email: joanne.hyde@cscuk.org.uk
Fax: +44 (0)20 7387 2655
Post: Commonwealth Scholarship Commission
c/o The Association of Commonwealth Universities
Woburn House
20-24 Tavistock Square
London WC1H 9HF
UK
Applications should be received at the above address by 4 April 2013. Applications received
after the closing date will not be considered.
Successful applicants will be notified by end May 2013.