f stuned form -master prog - deadline 15 mar 2014

8/12/2019 F StuNed Form -Master Prog - Deadline 15 Mar 2014

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www.nesoindonesia.or.id

Menara Jamsostek 20thFloor,

Jl. Gatot Subroto No. 38, Jakarta 12710

P +62 21 5290 2172

F +62 21 5290 2173

APPLICATION INFORMATION

MASTER PROGRAMME

A. INSTRUCTIONS FOR THE APPLICANT: Answer questions 1 through 8 clearly and completely (in English, typewritten). Do not change the lay out of the

original form. You will receive confirmation of receipt of your application within 2 weeks after the deadline by e-mail.

You may submit one application only (apply for one course only). Submiting more than one application (more thanone course) leads to disqualification.

The selection will be held in May 2014 and the result will be announced to the applicants at the latest by end ofJune 2014.

Failure to react to Nesos correspondence/e-mail within 5 working days can lead to cancellation of thescholarship.

If at any time after award of the scholarship it becomes clear that the applicant has made inacurate or incorrect

declarations in the application, the scholarship offer will immediately be revoked. TWO SETSof the application form and documentation are required.

Application form and documents will not be returned.

B. ENCLOSURES:Attach only certified copies of documents.

Admission letter by Dutch Higher Education Institution in the Netherlands for the course you are applying; Certificate copy of `TOEFL Internet-Based Test Examinee Score Report minimum 80 or `International English

Language Testing System Test Report Form (IELTS Report Form) min imum score 6; (If required applicant shouldbe able to provide NESO Indonesia the original test certificate)

Curriculum vitae, see format on website www.nesoindonesia.or.id; Copy SK for government officials or kontrak kerja for others;

Legalized copies of original diplomas and transcripts; Copy of KTP or copy of passport One recent photograph (3x4; colour)

The closing date is 15 March 2014Applications received after the closing date and incomplete application will not be processed.

Two complete sets of application form should be submitted. Completion in stages is not possible.

C. SELECTION PROCEDURE

Mar-Apr 2014 All applications are checked on their completeness. Incomplete applicat ions w il l not be

processed. Candidates who disqualify during this stage will receive a written notice.

Based on the formal StuNed criteria a list of eligible candidates is composed for the final

selection. This selection will result in a number of selected candidates and a ranked list of

reserve candidates. If among the final selection some candidates refuse or are not able to

receive the scholarship, candidates on the ranked reserve list will be awarded the scholarship.

May 2014 Selected candidates will be notified through a letter via e-mail, conveying extensive

information about procedures to be followed-up, the Rules and Regulations of the StuNed

Scholarship programme, a package with information about the Netherlands and information

about the visa procedure.

Jul 2014 Awardees will be invited for a pre-departure briefing in Jakarta.
http://www.nesoindonesia.or.id/http://www.nesoindonesia.or.id/


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APPLICATION FORMMASTER PROGRAMME 2014

TO BE FILLED IN BY APPLICANT

Name :

Male Female

E-mail 1 :

E-mail 2 :

FOR OFFICIAL USE ONLY

Documents Y N

Application form

Employer statement

Applicant's declaration

Admission letterIBT/IELTS

CV

SK

Original diploma

Original t ranscript

KTP or Passport

Eligibility Y N

2 years working exp.

Full time / Part time

Employer Statement

SK

GPA

IELTS/IBT

Study Abroad

Admission Letter

Chosen Programme

Tuition Fee

StuNed/NFP awardee

Selection Score

2014 EKN

2014 GMF

2014 JOJ

2014 MIB

Total score

Final Result Y / N

Scholarship Award

GPA: S1 S2

GPA MAX GPA MAX

IBT / IELTS: Test date:

Chosen Programme:

University in NL:

Duration: months

Employer:(Name of Institution)

City:

Province:

Employed Since: (dd/mmm/yyyy)

Applicant Position:

Position Held Since: (dd/mmm/yyyy)

Please attacha recent

photograph3 x 4

dd mm yy


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APPLICATION FORM MASTER PROGRAMME 2014

Please note that any false and/or incomplete declaration will lead to the termination of the StuNed scholarship . It is notallowed to extend or change the available space for each question, except for question 5.

1. PERSONAL INFORMATION

All data exactly as they (will) appear in your passport !

Name

Place / Date of Birth / (dd/mm/yyyy)

Marital Status Single Married Children Yes No

E-mail Address 1. 2.

Address

City: Province:

Telephone Home: Mobile:

Emergency Contact(or Next of Kin)

Relationship:

E-mail: Tel:

2. DESIRED MASTER PROGRAMME FOR WHICH YOU HAVE BEEN ADMITTED

Please enclose the admission letter from the University or Institution.

University Name

Study Programme

Program Period From: (dd/mm/yyyy) to (dd/mm/yyyy) Duration: months

Contact Person E-mail:

Total Tuition Fee EUR

Minimum TOEFL/IELTS

3. EDUCATIONAL BACKGROUND

a. Undergraduate EducationPlease enclose certified copies of relevant diplomas and transcripts

University or Institution Country:

Study Programme

Award Obtained Bachelor Other Year of graduation: GPA

b. Postgraduate Education or TrainingPlease enclose certified copies of relevant diplomas, degrees, certificates and transcripts.

University or Institution Country:

Study Programme From (dd/mm/yyyy) to (dd/mm/yyyy)

Award Obtained Master Other Year of graduation GPA

4. ENGLISH PROFICIENCY

Please enclose copy of your Test Result.

Test Name IBT TOEFL IELTS Test Score.............. Test Date:


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4. PRESENT EMPLOYMENT

Employer

Department/Directorate

Present Position

This Position Held Since (dd/mmm/yyyy)

Employed Since From: (dd/mmm/yyyy) To:(dd/mmm/yyyy)

Employment For Hours a week

Describe Your CurrentDuties AndResponsibilities

AddressCity: Province:

Phone: Fax:

E-mail: Website:

Brief description of YourEmployer

5. MOTIVATION STATEMENT

The statement should be typewritten and composed only by the applicant him/herself.

No. Criteria Explanation

A.Explain in 100 words the relevance ofthe chosen study programme to yourpersonal and career development

B.

Explain in 100 words the relevance ofthe chosen study programme to the

current development of yourorganization (long term developmentplan) and the sector you work in.

C.Describe in 100 words how the chosenstudy programme will benefitIndonesia in general.


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6. MISCELLANEOUS

How did you find out about the StuNedScholarship Programme for the very firsttime?

(TICK ONLY ONE ITEM) Nuffic Neso Indonesia website Nuffic Neso Indonesia presentation at the Neso office Nuffic Neso Indonesia presentation at your office Article in print media (please indicate ) Advertisement in print media (please indicate ..) Radio (please indicate)

Holland Education Fair (HEF) / European Higher EducationFair (EHEF)

Your institution Friends StuNed alumnus StuNed brochure/poster Nuffic Neso Indonesia office Others (please indicate .....................................)

Where/How did you get the informationabout the study programme for which youapply?

(TICK ONLY ONE ITEM) List of courses on the Neso website Holland Education Fair (HEF) / European Higher Education

Fair (EHEF) Nuffic website Dutch Higher Education Institution website Friends Your institution Nuffic Neso Indonesia office Others (please

indicate................................................................)

Have you applied for StuNed ScholarshipProgramme before?

No

Yes, yearProgram: MA SC Tailor Made

Have you ever been awarded ascholarship? Yes No

If so, from which organisation/donor?

For what period, for whichcourse/institution and in which countryhas it been granted?

For which other scholarshipprogramme(s) are you also applying atthis moment?


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7. STATEMENT BY THE EMPLOYER

*) the lowest level of employer authorisation should be at least echelon 2 command or the equivalent level in theMinistry or Institution. Failure upon providing sufficient authorisation will lead to disqualification of application.

I, the undersigned, being authorised tosupply the following particulars herebycertifies that:

Name of Applicant:

Employed Since: (dd/mm/yyyy)

Department/Directorate:

Current Position:

for hours a week

Position Held Since: (dd/mm/yyyy)

And is applying for a StuNed scholarship to follow a master programme in The Netherlands in the field of /name of the study programme:

Dutch Higher Education Institution (University) in the Netherlands :

Please explain fully why the master programme is important to your organisation (and to the applicantswork in the future) :

Do you guarantee that if the candidate is awarded with the scholarship, he/she will be given permission to

attend the program/course for the entire period of the programme? Yes No

Do you guarantee that, if the candidate is awarded with the scholarship, he/she will continue to be

employed by your organisation after completion of her/his study? Yes No

Which position will be offered to thecandidate after succesful completion ofher/his study? Department:

I certify that all my answers are true, complete and correct, and that if the candidate is awarded a StuNedscholarship, my organization will fully support and comply with all the formal obligations this entails.

Name, complete address & contact number (of organization) :

Name (of contact person) and Position*:

E-mail address:

Date:

Place:

Signature and Official Stamp (Obligatory): (please sign on materai (obligatory)

Acknowledgement from Human Resource Division

Name and Signature (Affix Official Stamp) Date:


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8. APPLICANTS DECLARATION

I completely understand the conditions under which the scholarship is offered, and if I am awarded aStuNed scholarship I agree:

1. to comply with all the formal obligations mentioned in the Rules & Regulations of StuNed;2. to return to my home country immediately after the programme has ended;3. to be available for the entire period of the study programme and be able to take part in the entire programme;4. to give permission to enter my personal data in a database which may be used at Nuffic Neso Indonesias

discretion to provide information for non- commercial purposes;5. to abide by the rules and regulations governing the student visa and stay permit;6. to fill in online end- of- course questionnaire;7. to act in such a manner that will not bring disrepute or cause any formal damage to any party involved in the

programme including the host institution, the image of Indonesian students in the Netherlands, Nuffic NesoIndonesia and accept to be called back to Indonesia without any formal appeal in case I breach this promise;

8. to participate in activities organised in relation to the StuNed scholarship whenever required;9. not to engage in employment in the Netherlands other than the allowed maximum of ten hours a week, and to

inform and update Neso of any details of such employment if any;10. not to hold another scholarship that would give any overlapping benefit without Nuffic Neso Indonesias written

approval.

Furthermore:

11. I commit to inform Nuffic Neso Indonesia immediately of any circumstances (serious illness, incident,incapacity, pregnancy, arrest, exclusion, death of relatives, problems at home, etc.) that occur during my studyand that might affect the progress of my course. I realise and consent that Nuffic Neso Indonesia mayterminate the scholarship;

12. I fully understand that if I am awarded a StuNed scholarship, it may be subsequently withdrawn if I fail to makeadequate progress, or for other sufficient cause determined by the Government of the Netherlands or theinstitution at which I am studying;

13. If reports from the host institutions give reason to doubt a successful continuation of the study, the scholarshipmay be terminated with immediate effect.

I certify that all my answers are true, complete and correct .

Date :

Name :

Place :

Signature : (please sign on materai(obligatory)

THE ORIGINAL APPLICATION FORM AND ITS ANNEXES SHOULD BE SENT TO:Nuffic Neso Indonesia

Menara Jamsostek 20th FloorJalan Jend. Gatot Subroto No.38

Jakarta 12710