IMAC Scholarship Application Form

PERSONAL INFORMATION
Name of Applicant
First Name*
Last Name*
Current School/College Attended
Last School/College Attended
Current Employer & Position
If Applicable
MaleFemale
Date of Birth*

MonthDayYear
Date
Country of Birth*
Country
Nationality*
Father's Name
Father’s Occupation
Father's Employer
Mother's Name
Mother’s Occupation
Mother's Employer
Sibling’s Name
Sibling’s Age
Sibling’s School/Occupation
- Sibling’s Name
- Sibling’s Age
- Sibling’s School/Occupation
- Sibling’s Name
- Sibling’s Age
- Sibling’s School/Occupation
- Sibling’s Name
- Sibling’s Age
- Sibling’s School/Occupation
- Sibling’s Name
- Sibling’s Age
- Sibling’s School/Occupation
- Sibling’s Name
- Sibling’s Age
- Sibling’s School/Occupation

Contact Details
Address*

Street Address

Street Address Line 2

DistrictState / Province

Postal / Zip Code
Home Address (if different)

Street Address

Street Address Line 2

DistrictState / Province

Postal / Zip Code
Email Address*
Primary Contact Number*
Secondary Contact Number (if different)
SingleMarried
Spouse’s Name & Address (if married)
Children’s Names & Ages (if any)
- Children’s Names & Ages (if any)
- Children’s Names & Ages (if any)
- Children’s Names & Ages (if any)

EDUCATIONAL ATTAINMENTS

Please list below the Examining Board(s), Subjects and Grades of your educational attainments and provide transcripts etc. NB. DO NOT SAY “See Attached”.
1. Examining Board (eg CXC, GCSE, UCCI - Associates Degree etc)*
Subject*
Grade Attained*
2. Examining Board (eg CXC, GCSE, UCCI - Associates Degree etc)*
Subject*
Grade Attained*
3. Examining Board (eg CXC, GCSE, UCCI - Associates Degree etc)*
Subject*
Grade Attained*
4. Examining Board (eg CXC, GCSE, UCCI - Associates Degree etc)*
Subject*
Grade Attained*
5. Examining Board (eg CXC, GCSE, UCCI - Associates Degree etc)
Subject
Grade Attained
6. Examining Board (eg CXC, GCSE, UCCI - Associates Degree etc)
Subject
Grade Attained
7. Examining Board (eg CXC, GCSE, UCCI - Associ ates Degree etc)
Subject
Grade Attained
8. Examining Board (eg CXC, GCSE, UCCI - Associates Degree etc)
Subject
Grade Attained
- 9. Examining Board (eg CXC, GCSE, UCCI - Associates Degree etc)
- Subject
- Grade Attained
- 10. Examining Board (eg CXC, GCSE, UCCI - Associates Degree etc)
- Subject
- Grade Attained
- 11. Examining Board (eg CXC, GCSE, UCCI - Associates Degree etc)
- Subject
- Grade Attained
- 12. Examining Board (eg CXC, GCSE, UCCI - Associates Degree etc)
- Subject
- Grade Attained
- 13. Examining Board (eg CXC, GCSE, UCCI - Associates Degree etc)
- Subject
- Grade Attained
- 14. Examining Board (eg CXC, GCSE, UCCI - Associates Degree etc)
- Subject
- Grade Attained
- 15. Examining Board (eg CXC, GCSE, UCCI - Associates Degree etc)
- Subject
- Grade Attained
- 16. Examining Board (eg CXC, GCSE, UCCI - Associates Degree etc)
- Subject
- Grade Attained

EDUCATION and FINANCING INFORMATION

(all figures in US$ please unless otherwise stated)
First Choice
Degree Sought*
Major Field of Study*
Name of Accepting Institution *
Address of Accepting Institution*
City & Zip Code*
State*
Country*
Expected Commencement Date*

MonthDayYear
Years needed to complete course: (if already enrolled, include expected graduation date)*
Annual cost of studies

Please provide the official cost information from your university and include copies of the source details on the final page of this application. If applying for a scholarship in a currency other than USD, please convert the amount using the current exchange rate and enter the figures in USD below.
Tuition & Fees per Annum*
Room & Board per Annum*
Books & Supplies per Annum*
Estimated Travel Expenses per Annum*
Other (specify)
Enter additional expense type and annual cost
Total Annual Fees etc.*
Final annual cost
- Degree Sought
- Major Field of Study
- Name of Accepting Institution
- Address of Accepting Institution
- City & Zip Code
- State
- Country
- Expected Commencement Date
  
  MonthDayYear
- Years needed to complete course: (if already enrolled, include expected graduation date)
- Annual cost of studies
  
  Please provide the official cost information from your university and include copies of the source details on the final page of this application. If applying for a scholarship in a currency other than USD, please convert the amount using the current exchange rate and enter the figures in USD below.
- Tuition & Fees per Annum
- Room & Board per Annum
- Books & Supplies per Annum
- Estimated Travel Expenses per Annum
- Other (specify)
  Enter additional expense type and annual cost
- Total Annual Fees etc.
  Final annual cost

How You intend to finance your studies. If none, write none in each applicable space.
Personal Savings*
Enter amount in US$ or write 'None' if not applicable
Family Contribution (on the final page of this application, attach a letter from parent/guardian or bank regarding the availability of additional funds)*
Enter amount in US$ or write 'None' if not applicable
List scholarships currently held and amounts: (attach documentation on final page)
Scholarship Name and Amount (US$)*
Enter the scholarship name and the awarded amount in USD. If none, write 'None'
Scholarship Name and Amount (US$)*
Enter the scholarship name and the awarded amount in USD. If none, write 'None'
Scholarship Name and Amount (US$)*
Enter the scholarship name and the awarded amount in USD. If none, write 'None'
List scholarships you have applied for or will apply for and the estimated amounts.
Scholarship Name and Estimated Amount (US$)*
Enter the scholarship name and the estimated amount in USD. If none, write 'None'
Scholarship Name and Estimated Amount (US$)*
Enter the scholarship name and the estimated amount in USD. If none, write 'None'
Scholarship Name and Estimated Amount (US$)*
Enter the scholarship name and the estimated amount in USD. If none, write 'None'
IMAC Scholarship Fund Request
Scholarship amount being requested from IMAC*
$USD
Total Financing Required (this should be equal to "Total Annual Fees" above)*
$USD
You may write any additional comments in this space or preferably in a separate letter:

SUMMARY
Applicant Signature:*
Application Support Requirements Documentation Upload Checklist.

Please ensure that all documents are clear and legible.
Recent Photograph (clear head-and-shoulders image).*

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Birth Certificate*

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Passport Photo Page*

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Caymanian Acknowledgement Letter from WORC or Cayman Status Letter (whichever is applicable)*

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A two-page (max) letter introducing yourself, your family, interests, community involvement, education, and career goals. Explain your chosen degree, university, and ambitions. You may also include a resume-style summary.*

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Character Reference Letter (Not from a family member). All references must be on official letterhead, signed, and include the reference provider's contact details. References may also be submitted directly by the referee via email to esf@imac.ky.*

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Academic reference Letter. All references must be on official letterhead, signed, and include the reference provider's contact details. References may also be submitted directly by the referee via email to esf@imac.ky.*

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School transcript or last two school reports.*

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Proof of grades attained (or predicted) at IGCSE, CXC, ‘AS’, ‘A2’ (and GPA and SAT scores if you have these).*

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Attach details of all scholarships that have been awarded or applied for.

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University details: Acceptance/offer letter, cost of course with copies of the source information from your college of first choice together with the entrance requirements (eg A2 grades required).*

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Family contribution: attach a letter from parent/guardian or bank regarding the availability of additional funding*

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Should be Empty:

PERSONAL INFORMATION

Name of Applicant

Contact Details

EDUCATIONAL ATTAINMENTS

EDUCATION and FINANCING INFORMATION

First Choice

Annual cost of studies

Annual cost of studies

How You intend to finance your studies. If none, write none in each applicable space.

List scholarships currently held and amounts: (attach documentation on final page)

List scholarships you have applied for or will apply for and the estimated amounts.

IMAC Scholarship Fund Request

SUMMARY

Application Support Requirements Documentation Upload Checklist.