Application Form
Exclusive Undergraduate Scholarships In Biomedical Engineering Technology and Embedded Systems For Africa
Email-1
example@example.com
Submission Date
-
Day
-
Month
Year
1- Applying For
*
Please Select
ADP in Biomedical Engineering Technology
ADP in Embedded Systems
2- Full Name
*
Full Name, as per passport
3- Nationality
*
4- Gender
*
Please Select
Male
Female
Other
5- WhatsApp Number
*
6- Current Country of Residence
*
7- Religion
*
8- Email
*
example@example.com
8- Date of birth
*
-
Day
-
Month
Year
9- Passport number / NIC number
*
10- Expiry Date (Passport / NIC)
*
-
Day
-
Month
Year
11- Marital status
*
Please Select
Single
Married
Divorced
Widowed
12- Number of children (if any)
*
13- Current address
*
14a- Details of education (Please state your Highest degree, institution, grade)
*
14b- Upload clear scan of Transcripts / Degrees
*
Upload
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All Transcripts/ Degrees shall be uploaded as one file in .pdf or .jpg formats only. File size must not exceed 2MB.
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15- Details of any previous visits abroad
*
0/100
16- English language proficiency level (tick the relevant)
*
Please Select
Beginner
Intermediate
Proficient
17a- Medical fitness
*
*Declare any medical condition you have (this will not affect the outcome of your application.
17b- Medical fitness
*
*Declare if you are expecting a child.
18- Current/previous employment
*Name of the organization/employer and your Job description
19- Scan of one recommendation letter (current/most recent Institution)
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The file should be in .pdf or .jpg format only. File size must not exceed 300kb
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20- Upload Clear scan of passport / NIC
*
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The file should be in .pdf or .jpg format only. File size must not exceed 300kb
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21- A detailed CV enlisting all educational/professional activities, research publications and a clear picture, from not more than 6 months ago.
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The file should be in .pdf format only. File size must not exceed 500kb
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Declaration
*
By signing this form, you acknowledge that all the information provided is true, and agree to comply with all terms and conditions of this fellowship.
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