LEAD 4africa Scholarship Application

Scholarship Application
- Read instructions below carefully and then fill out the spaces provided from Section A-F as candidly as possible.
- You are advised to attach relevant photocopies to this form in support of all verifiable statements.
- Incomplete information will lead to rejection of the application.
- Applicants with 2 principal passes and above are encouraged to apply.
- LAST DATE FOR SUBMISSION OF COMPLETED APPLICATION FORM IS FRIDAY, 18-JULY-2025.
SECTION A: Applicant's Personal Details

Do not type or add a new name. Start typing your name and select it from the dropdown list that appears. Only names from the list are accepted.
Name:*
Please start typing your name and then select your name from the list that appears.
Current City or Town:*
Current Country:*
Other Current Country:
Telephone Number:*
Please add the country code in front of your number. (Example: +256, +211, etc.)Format: (000) 000000000.
WhatsApp Number:*
Please add the country code in front of your number. (Example: +256, +211, etc.)Format: (000) 000000000.
Email:*
example@example.com

SECTION B: Family Background
Mother:*
Mother Name:*
Mother Phone Number:
Please add the country code in front of your number. (Example: +256, +211, etc.)Format: (000) 000000000.
Mother Email:
example@example.com
Mother Occupation:
Either now or previously
Mother Deceased Reason:
Father:*
Father Name:*
Father Phone Number:
Please add the country code in front of your number. (Example: +256, +211, etc.)Format: (000) 000000000.
Father Email
example@example.com
Father Occupation:
Either now or previously
Father Deceased Reason:
Who is your co-signing guardian?*
Co-signing Guardian Name:*
Co-signing Guardian Relationship:*
Co-signing Guardian Phone Number:*
Please add the country code in front of your number. (Example: +256, +211, etc.)Format: (000) 000000000.
Co-signing Guardian Email Address:
example@example.com
Co-signing Guardian Occupation:*

Summarize your educational and professional goals/aspirations:
Have you been engaged as a leader, a volunteer, or a community service member? *
What important contributions have you made in your role or leadership position? *
Describe your educational and professional goals/aspirations. *
How will LEAD4africa scholarships assist you to attain the above goals/aspirations? *

SECTION D: Applicant's Work Experience Details (if any):

Please summarize the details of work experience (internship, volunteering position, community service, etc.) gained after A-Level in the table below.
Organization Name:
Organization Address:
Job Title:
Start Date:

DayMonthYear
End Date:

DayMonthYear
Total Emoluments:
Reason for Leaving:
2nd Organization Name:
2nd Organization Address:
2nd Job Title:
2nd Start Date:

DayMonthYear
2nd End Date:

DayMonthYear
2nd Total Emoluments:
2nd Reason for Leaving:

SECTION E: Attestation by the Applicant

Declaration: I hereby confirm and certify that the information I have filled in this form is correct and true to the best of my knowledge.
Print Name:*
Signature Date:*

DayMonthYear
Should be Empty:

SECTION A: Applicant's Personal Details