ASEAN UNDERGRADUATE TUITION FEES SCHOLARSHIP

APPLICATION FORM
Please complete this form in English. Add additional pages if necessary.

1. PERSONAL DETAILS
I am a citizen of the following ASEAN country:
Brunei Cambodia Indonesia Laos Malaysia Myanmar
Philippines Singapore Thailand Vietnam

Please state your FULL NAME as written in your passport or birth certificate:
SURNAME OR FAMILY NAME (PRINT CLEARLY):

FIRST OR GIVEN NAMES:

Male Female Date of birth:

DD/MM/YEAR

2. CONTACT DETAILS
ADDRESS:

TELEPHONE: EMAIL ADDRESS:

FATHERS OCCUPATION:

MOTHERS OCCUPATION:

3. ACADEMIC HISTORY
Attach full documentation to support each entry:

SECONDARY SCHOOL/INSTUTION: YEARS ATTENDED FROM TO

HIGHEST QUALIFICATION:

ASEAN UNDERGRADUATE TUITION FEES SCHOLARSHIP APPLICATION FORM 1

ASEAN UNDERGRADUATE TUITION FEES SCHOLARSHIP
APPLICATION FORM
4. WHAT IS YOUR ENGLISH LANGUAGE PROFICIENCY?
Tick the following statements that apply to you, and attach official results where available:

I have completed my secondary or tertiary studies at an institution, in a native English-speaking country where English is the language
used for instruction.
I have sat TOEFL in the past two years and my score was 80 or more in the internet-based test.
I have sat IELTS in the past two years and my score was 6.0 or more, with no subscore less than 5.5.
I have sat and passed another internationally recognised English language proficiency test. Please specify below.

5. WHAT DEGREE(S)/MAJOR DO YOU WISH TO STUDY AT VICTORIA UNIVERSITY OF WELLINGTON?

Example: Bachelor of Arts (History). It is important to give a second choice.

FIRST CHOICE SECOND CHOICE

6. WHAT IS YOUR PROPOSED CAREER?

7. GIVE DETAILS OF ANY EXTRACURRICULAR CLUBS OR GROUPS WITH WHICH YOU ARE INVOLVED:

PLEASE INCLUDE THE FOLLOWING WITH YOUR COMPLETED APPLICATION FORM :

A separate page outlining why you would like to study at Victoria University of Wellington and why Wellington and/or New Zealand appeals
to you as a study destination. Include any other reasons why this scholarship would be important to you.
Two written references (these should not be written by friends or family members).
Proof of your English language proficiency (such as a copy of your IELTS certificate).
Copies of your most recent school reports and testimonials.
Copies of your most recent academic results and forecast results if applicable.

Where results from secondary school study and/or university foundation study are not available, it is essential that an original signed set of
forecast results are provided by the applicants educational institution.
Documents submitted in support of this application must be in English. Documents must be originals or certified copies of the original.
Certification of documents must be done by a recognised official or by the institution that issued the document and must bear the official
stamp and signature of the certifier. If you have already provided the certified and stamped documents with your enrolment application,
please send a copy of these documents with your scholarship application. Electronic copies cannot be accepted.

ASEAN UNDERGRADUATE TUITION FEES SCHOLARSHIP APPLICATION FORM 2

HOW DID YOU HEAR ABOUT THIS SCHOLARSHIP?

DECLARATION
I declare that to the best of my knowledge the information supplied above and enclosed in support of my application is correct and complete.
I agree to abide by the conditions determined by Victoria University of Wellington.
I declare that I have not personally or as a dependant applied for migration, nor been granted permanent residence status in New Zealand.
I declare that I have submitted an application to study at Victoria as an undergraduate International student in 2018.

SIGNED DATE DD/MM/YEAR

Please return your completed application to reach the following address by 31 October 2017:

International Programmes Office

Victoria International
PO Box 600
Wellington
New Zealand

Emailed applications will not be accepted.

ASEAN UNDERGRADUATE TUITION FEES SCHOLARSHIP APPLICATION FORM 3