How to complete the form - Eastern and Southern Africa ...



53644808763000622308763000Inter-University Council for East AfricaP O Box 7110, Kampala, UgandaTel: +256 773181662E-Mail: exsec@Website: Inter-University Council for East AfricaP O Box 7110, Kampala, UgandaTel: +256 773181662E-Mail: exsec@Website: MASTERS FELLOWSHIP APPLICATION FORM Supporting Young Talented Female Scientists to Become Future Leaders MASTERS FELLOWSHIP APPLICATION FORM Supporting Young Talented Female Scientists to Become Future Leaders 4869180185420PLEASE ATTACH A RECENT PASSPORT SIZE PHOTOGRAPH(3x4)00PLEASE ATTACH A RECENT PASSPORT SIZE PHOTOGRAPH(3x4)Reference No:(for official use)Received on:(for official use)How to complete the form1.Please complete the application form in type, or write in CAPITAL letters and BLACK ink.2.Please quote your e-mail address, as all correspondence will be via e-mail.3.Please make a copy of the form for yourself before sending it to IUCEA/RFU.4.Fill in all the sections, otherwise delays will occur when processing your application.5.The closing date for fellowship applications to be received is June 4 2018. Fellowship applications received after the closing date will not be considered. A. Personal details (as they appear on your passport)Last/family name:- - - - - - - - - - - - - - - - - - - - - - - - - - - - - -First name:- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Other names:- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Address: - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -Phone: - - - - - - - - - - - - - - - - - - - - - - - - - - - - -E-mail: - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -Gender:- - - - - - - - - - - - -Date of birth(day/month/year) / /Passport No: - - - - - - - - - - -- - - - - - - - - - -Place of Issue:- - - - - - - - - - -- - - - - - - - - - -Date of Issue: - - - - - - - - - - -- - - - - - - - - - -Date of Expiry:- - - - - - - - - - -- - - - - - - - - - -Nationality of Birth- - - - - - - - - - - - - - - - Current Nationality- - - - - - -- - - - - - - - - -B. Programme of studyTitle of degree programme admitted to:- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -Admission number: - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -Name and address of university:- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -Name of African Center of Excellence:- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -C. Education history and qualificationsPlease list qualifications and grades which you have already obtained starting with the most recent:Dates attendedSchool, university or college / countryQualification name (e.g. high school certificate, BSc in…)Grade/classDate obtained D. Work experiencePlease describe any work experience which is relevant to your proposed study programme, starting with your most recent position:Employment DatesName of employer/organisationJob title and responsibilitiesE. Publications, Conferences, awardsList articles you have published or presented in conferences, and award for outstanding achievement, if any.F. Personal statementThese fellowships are awarded on the basis of academic ability, future potential and relevance, and the selectors will pay special attention to the information you provide here. Please tell us about your academic achievements and ambitions. In particular, please explain why you have chosen your particular field of study and its importance to the region’s development:G. ReferencesName and PositionContact Address H. Declaration I hereby declare that I have understood and comply with the eligibility criteria, and I make a true statement about my details. Signature (or type your name):Date: I. Checklist Completed application form Recent passport-size photograph Summarized CV with names and contacts of two refereesCertified copies of academic certificates and transcripts Certified copies of passport or national identity card indicating citizenship Copy of admission letter from one of the host universities (please refer to the attached table on Countries, ACEs and Universities)Two (2) reference letters with contact addressesIn addition, applicants must scan and produce electronic copies of all the above documents (converted to PDF format) and send by e-mail to exsec@ with a copy to ace2rfu@ to be received by June 4 2018. Completed application form Recent passport-size photograph Summarized CV with names and contacts of two refereesCertified copies of academic certificates and transcripts Certified copies of passport or national identity card indicating citizenship Copy of admission letter from one of the host universities (please refer to the attached table on Countries, ACEs and Universities)Two (2) reference letters with contact addressesIn addition, applicants must scan and produce electronic copies of all the above documents (converted to PDF format) and send by e-mail to exsec@ with a copy to ace2rfu@ to be received by June 4 2018. ................
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