2021-2022 SCHOLARSHIP ONLINE APPLICATION FORM

UNIVERSITY/COLLEGE INFORMATION
UNIVERSITY/COLLEGE: *
SCHOOL ADDRESS: *
SCHOOL"S WEBSITE URL (Address):
SCHOOL"S MAIN PHONE NUMBER: *
SCHOOL"S MAIN FAX NUMBER:
ACADEMIC INFORMATION
DATE ADMITTED: *

Month Day Year
Date
METHOD OF ADMISSION: *
REGISTRATION NUMBER:
SCORE: *
MATRICULATION NUMBER: *
COURSE OF STUDY: *
DURATION OF STUDY: *
EXPECTED GRADUATION DATE *

Month Day Year
Date
CURRENT LEVEL: *
O" LEVEL RESULTS (Please list the subjects and the results: e.g. Mathematics A1): *
LAST SESSION"S GPA: *
LAST SEMESTER"S GPA: *
Did you write your Essay, in a separate document? *

Yes No
SUPPORTING DOCUMENTS (essay, transcripts, admission letter, student and LGA ids, other documents necessary to evaluate your qualification and eligibility for the scholarship)
Attachments (provide all supporting documents requested in the instruction above, including the essay document) *

Select File

Cancel of

CURRENT PRIMARY SPONSOR
IS ONE OR BOTH OF YOUR PARENTS SOLELY RESPONSIBLE FOR YOUR SCHOOL EXPENSES? *
IF NOT YOUR PARENT(S), WHO IS THE CURRENT PRIMARY SPONSOR RESPONSIBLE FOR YOUR SCHOOL FEES AND EXPENSES?: *
IF YOUR CURRENT PRIMARY SPONSOR IS OTHER, PROVIDE THE FIRST AND LAST NAME AND THE RELATIONSHIP TO YOU *
PROVIDE THIS PRIMARY SPONSOR"S OR YOUR ANNUAL INCOME (in NAIRA): *
CONFLICT OF INTEREST STATEMENT
ARE YOU RELATED TO A MEMBER OF THE NDOKWA ASSOCIATION IN AMERICA? *
IF YOUR ANSWER IS "YES", PLEASE PROVIDE THE MEMBER"S NAME: *
SELECT YOUR RELATIONSHIP TO THE MEMBER: *

SECTION 3: TERMS OF AWARD AND APPLICATION ACCEPTANCE
I affirm that the information and documents that I have supplied with this application, and that I will continue to supply for all ongoing verifications are correct, true and accurate. If at any time, the information or document that I supplied is found to be false or inaccurate, this application and any award that I may have received shall be nullified or withdrawn immediately. I am aware that Ndokwa Association In America, Inc., (NAIA) at its sole discretion, may seek any legal redress, both civilly and criminally for a violation of this affirmation. Furthermore, all erring individuals shall be, forever barred from receiving benefits from NAIA.
Affirmed *

Yes
Should be Empty:

CONFLICT OF INTEREST STATEMENT