edufair student application form - print version · 2018. 9. 15. · title: microsoft word -...

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PRE-REQUISITES

Citizenship of South Africa Currently in Grade 12 Ambassador of EduFair’s intended profile, which is represented by the following characteristics:

1. Positive attitude 2. Strong willingness to learn 3. Well-rounded 4. Engaging 5. Community-minded

Intention to study at the University of the Witwatersrand, University of Johannesburg or the University of Pretoria. Student has the ambition to become the first person in your direct family to attain a tertiary education Student has not been awarded any other conflicting scholarships The application form and other requirements are to be sent to us via email ([email protected]) by no later than 15 September 2018

Academic Requirements: Minimum C [Extended level] average for Grade 12 April results) Certified copies of Academic/Extra-curricular awards/recognition must be provided for Grade 10, 11 and 12.

STUDENT APPLICATION FORM 2018

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IMPORTANT NOTE TO APPLICANTS • All shortlisted candidates are required to have independently written all necessary final year (matric) exams during 2018. Failure

to write any exams which are required for university acceptance in 2019 will exclude you from the selection process. • The scholarship is null and void if the student is not finally accepted into his or her choice of study and EduFair is not obliged to

support the student in any way, but may do so at its own discretion • All information requested by EduFair will be kept confidential. We will not disseminate any personal information unless

specifically authorised on page 8 of this application. • Submission of this application form to EduFair does NOT automatically guarantee that the applicant will be awarded the

scholarship. • Application forms received after 15 September 2018 (17h00) will NOT be considered. • Please retain a copy of your completed application form and other relevant documents for your own records. Only applications

received in ENGLISH will be accepted. • EduFair contact details:

Email: [email protected] | Website: https://www.edufair.nl Selection Process

Step 1 Submit promotional video of yourself 15 August 2018 Step 2 Submit completed application form 15 September 2018 Step 3 Students interviewed 15 – 30 September 2018 Step 4 Student selected 30 September 2018

Please note that applicants will be contacted after each step of the selection process to notify them of their application status. Application Checklist You will need to make sure that all requirements are carefully met and the correct information is provided so that your application can be processed. ❏ Certified copy of your ID ❏ Certified copy of your final Grade 10 report ❏ Certified copy of your final Grade 11 report (most recent) ❏ Certified copy of your Grade 12 report (where available) ❏ Recent passport-size photograph ❏ Promotional video of yourself ❏ Certified copies of Academic/Extra-curricular awards/recognition/supporting documentation obtained in Grade 10, 11 and 12 ❏ Stamped and signed reference from an Educator enclosed with application in separately sealed envelope ❏ I am currently in Grade 12 ❏ Parent’s/ Legal guardian’s signature (page14) Applicant’s signature (page14) ❏ Certified copy of your Parent’s/ Legal guardian’s IDs ❏ Application is completed in ENGLISH

ATTACH A RECENT PASSPORT SIZE PHOTOGRAPH OF APPLICANT

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1. STUDENT INFORMATION

Title: Mr / Miss / Mrs (Please circle the most appropriate)

First name(s):

Surname: Middle name(s): Date of birth (DD/MM/YYYY): Gender: M / F / Gender neutral

(Please circle the most appropriate) Country of citizenship: Ethnic group: ID / passport no: Do you have any form of disability? (If yes, please specify)

………………………………………………………………………………………………………………….. Marital status: Single / Married / Divorced / Widowed (Please circle the most appropriate)

Home address Postal address (if different to home address) Street address: Street address / P.O. Box: Suburb: Suburb: City: City: Region: Region: Country: Country: Home phone: Mobile phone: Email address: Home language: Skype ID: Other languages: Second language: Preferred method of contact: Email / Home phone / Mobile phone

(Please circle the most appropriate)

2. EMERGENCY CONTACT INFORMATION

Title: Mr / Miss / Mrs (Please circle the most appropriate)

First name(s):

1st contact number: Surname: 2nd contact number: Relationship to student

(e.g. Mother / Father / Uncle): Email address:

3.1. PARENT OR GUARDIAN DETAILS (1)

Title: Mr / Miss / Mrs / Dr (Please circle the most appropriate)

First name(s):

Surname: Middle name(s): Date of birth (DD/MM/YYYY): Parent / Guardian Country of citizenship: Marital status: Single / Married / Divorced / Widowed

(Please circle the most appropriate) ID / passport no: Relationship to student

(e.g. Mother / Father / Uncle): Occupation: Highest level of education:

None / High School / College / University / Post graduate (Please circle the most appropriate)

Home address Contact details Street address: Home phone: Suburb: Mobile phone: City: Email address: Region: Preferred method of contact: Email / Home phone / Mobile phone

(Please circle the most appropriate) Country:

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3.2. PARENT OR GUARDIAN DETAILS (2)

Title: Mr / Miss / Mrs / Dr (Please circle the most appropriate)

First name(s):

Surname: Middle name(s): Date of birth (DD/MM/YYYY): Parent / Guardian Country of citizenship: Marital status: Single / Married / Divorced / Widowed

(Please circle the most appropriate) ID / passport no: Relationship to student

(e.g. Mother / Father / Uncle): Occupation: Highest level of education:

None / High School / College / University / Post graduate (Please circle the most appropriate)

Home address Contact details Street address: Home phone: Suburb: Mobile phone: City: Email address: Region: Preferred method of contact: Email / Home phone / Mobile phone

(Please circle the most appropriate) Country: 4. HOUSEHOLD INCOME

Combined monthly household income of parent(s) and / or guardian(s) before deductions: (Please tick the relevant box)

R0 – R4,999 R5,000 – R9,999 R10,000 – R19,999 R20,000 – R29,999 > R30,000

Combined monthly expenses:

5. ACADEMIC HISTORY

School name: City: Street address: Region: Type of school: Private Public

Government Church

School phone number: Grade 12 completion year: Grade 11 results: Grade 10 results: Position in grade: Total no. of pupils in grade: Position in grade: Total no. of pupils in grade:

Subject Percentage (%) Subject Percentage (%)

List all academic achievement awards and/or recognition (please indicate the level of achievement e.g. School, Community, Town, Regional, Provincial, National, International): (Please attach supporting documentation with your application.)

a

s

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6. INTENDED UNIVERSITY STUDIES (2019)

Order of priority Faculty Name of degree University*

* University choice – EduFair currently offers the Fellowship opportunity at Wits, UJ and UP. You may choose the same university more than once. Please note: Applicants need to be based at the university of study – no correspondence applicants will be accepted. 7. 7. EXTRA-MURAL ACTIVITIES (Please list any achievements or awards at high school or community.)

Leadership: Please indicate current or previous leadership roles.

Institution Position Duration of involvement Level Reference

Community service: Please indicate any community involvement in which you participate or have participated.

Organisation Nature of involvement Duration of involvement Level Reference

Sport: Please indicate the sports that you play regularly, and the highest level obtained.

Sport Level Regional/National Special achievements Reference

Cultural: Please indicate the sports that you play regularly, and the highest level obtained.

Sport Level Regional/National Special achievements Reference

8. TELL US ABOUT YOU

8.1. What inspires you?

………………………………………….……………………………………………………………………………………………………………………………………………………….…………………………………………………………………………………………………………………………………………….…………………………………………………………………………………………..………….………………………………………………………………………………………………………………….………… …………………………………………………….……………………………………………………………………………………… …………………………………………………….………………………………………………………………………………………

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8.2. What informed your decision to study towards your chosen degree? What do you think you will enjoy about your chosen field/career and which areas do you think you may find challenging?

………………………………………….……………………………………………………………………………………………………………………………………………………………………………………………….………………………………………………………………………………………….……………………………………………………………………………………………………………………………………………………………………………………………….………………………………………………………………………………………………………………….…………………………………………………………………………

8.3. What are your top three strengths and your three development areas? List them and give an example of each. How did these strengths and development areas inform your decision in selecting your chosen field of study?

………………………………………….……………………………………………………………………………………………………………………………………………………….………………………………………………………………………………………………………………………………….……………………………………………………………………………………………………………………………………………………….…………………………………………………………………………………………………………………………………………………………………………………….………………………………………………………………………………………………………………….…………………………………………………………………………

8.4. How are you demonstrating excellence in other areas of your life outside your academic achievements? What actions/steps did you take to achieve this excellence? How has your excellence been recognised?

………………………………………….…………………………………………………………………………………………………………………………………………….……………………………………………………………………………………………………………………………………………………….…………………………………………………………………………………………………………………………………………….……………………………………………………………………………………… 8.5. You would’ve seen that as part of the selection process section that you’re required to submit a promotional video

of yourself. We look forward to getting to know who you are! Please create a video of between two and five minutes in length which includes, at least, the following topics:

Your name and age Where you’re from Your family background and your upbringing What your hobbies are What your choice of study is and why you’re passionate about it Why you are the perfect candidate for our program How you see the program enabling your future Where you see yourself in ten years

We value creativity, so please feel free to use your own initiative to say whatever you feel is appropriate.

8.6. In the pre-requisites section we mentioned the five key characteristics which we find most important, being: Positive attitude Strong willingness to learn Well-rounded Engaging Community-minded

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Please describe why you believe that you fit this profile and share some examples of how you’ve demonstrated these characteristics in the past.

………………………………………….…………………………………………………………………………………………………………………………………….……………………………………………………………………………………………………………………………………………………….…………………………………………………………………………………………………………………………………………………….………………………………………………………

9. SHAPING THE FUTURE OF SOUTH AFRICA, ONE STEP AT A TIME One of our key principles is that past recipients’ of the scholarship are expected to give back, not only to the EduFair community itself, but also to the broader South African community as a whole. Our aim is to develop people who are also willing to do the same for others. This will create a snowball effect that will have a long-term positive effect on the welfare of South Africa. With this principle in mind, please write between 100 and 300 words on each of the following topics:

1. What you have done in the past to demonstrate a positive impact on your community, whether it be at your school, your town/village/suburb or your sports team.

2. How you will leverage from the scholarship and related studies to generate a positive impact on your community in the future.

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STATEMENT OF INTEGRITY I hereby certify that I have provided accurate information in this application. I authorise all persons or entities to provide any relevant information in their possession to EduFair or its agent for use in considering me for admission or verifying my credentials for admission. I expressly waive any required notice to me. I understand and agree that any misrepresentation or omission of facts in my application will justify denial of admission, the cancellation of admission or expulsion. I hereby grant permission to EduFair to utilise the information provided in this application for the purposes of its activities. This application is my own honest statement to the Admissions Committee. CONSENT By signing this application you are giving EduFair consent to: Share your personal information with internal and external assessors for assessment purposes To use your information for research purposes (full confidentiality will be observed) To store your information on our data management system Share your promotional video with the purpose of promoting EduFair and its causes (note: if you have any strong objections related

to the sharing of your video the onus is on you to communicate these to EduFair during the application process). EduFair, undertakes to protect your information and to ensure that is not used for any purpose outside of this application process Applicant’s signature: _____________________________________________ Date: ________________________ Parent’s/Legal guardian’s signature: _________________________________ Date: ________________________ EduFair is proud to have partnered with various funding organizations working with(in) universities and other related projects. These partners share an interest in providing further opportunities to candidates who show potential within this selection process but who are not ultimately successful. While these alternative opportunities are by no means guaranteed, would you consent to us communicating your personal particulars to these 3rd parties?

Yes No

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REFERENCE FROM EDUCATOR

I, the undersigned, confirm the following concerning the applicant:

Applicant first name: Surname: Applicant’s position in grade (grade 11): Number of learners in class (grade 11): Number of years that I have known the applicant: Do you believe that the applicant deserves this scholarship opportunity, and why? We are specifically targeting individuals who have not had a privileged life and whose family has not had the opportunity of obtaining tertiary education in the past. As far as you’re aware, please confirm that the applicant fits this profile. Are you aware of any other potential scholarships that the applicant has applied for or already obtained? If so, please describe these and their status.

OFFICIAL SCHOOL STAMP

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EDUFAIR’S FIVE PILLARS EduFair is looking to support individuals who demonstrate the following characteristics and display them on a consistent basis:

1. Positive attitude 2. Strong willingness to learn 3. Well-rounded 4. Engaging 5. Community-minded

Having read the characteristics above, I recommend the applicant for an EduFair scholarship because:

………………………………………….……………………………………………………………………………………………………………………………………………………….………………………………………………………………………………………………………………….…………………………………………………………………………………….…………………………..….………………………………………………………………………………………………………………….……………………..……….………………………………………………………………………………………………………………….………………..

This reference was given by me, the undersigned, in my capacity as:

School name: Title: Mr / Miss / Mrs / Dr (Please circle the most appropriate)

Current position

First name(s): Surname: Work phone: Mobile phone: Email: School website:

Signature: ______________________________________________________ Date: ____________________

edufair student application form - print version · 2018. 9. 15. · title: microsoft word -...

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