UNIVERSITY OF CAMBRIDGE



THE PRINCE PHILIP SCHOLARSHIP APPLICATION FORM

(for admission to Cambridge in 2021)

This form is to be completed by applicants applying for the Prince Philip Scholarship for entry as undergraduates to the University of Cambridge in 2021.

(You must read the Application Guidelines, including the Personal Information Collection Statement set out therein, carefully before completing this application form. Both this form and the Application Guidelines can be downloaded from the website of The Friends of Cambridge University in Hong Kong: . The website also contains useful information about the Prince Philip Scholarship.)

PLEASE PRINT ALL INFORMATION IN BLOCK CAPITALS.

AFFIX RECENT

PHOTOGRAPH HERE

(WRITE YOUR NAME ON THE BACK OF THE PHOTOGRAPH)

NAME IN CHINESE CHARACTERS ..........................................................

SURNAME .......................................................................................................

FIRST NAME ..................................................................................................

OTHER NAMES .............................................................................................

PREFERENCE COLLEGE ............................................................................

(Please read Section 01 and paragraph 7-D of the Application Guidelines carefully before choosing your preference college. Write “Open” if making an open application.)

PROPOSED SUBJECT OF STUDY AT UNIVERSITY OF CAMBRIDGE (Please read Section 02 and paragraph 7-E of the Application Guidelines carefully.)

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|Summary ( Please tick and complete as appropriate) |

| |

|Email address for correspondence: _________________________________________________ |

|(Please read Section 04 of the Application Guidelines carefully.) |

|Contact mobile phone number : (+ ) _____________________________________________ |

|I am now studying |□ in Hong Kong. □ in UK. |

| |□ in:___________________________________(please specify). |

|□ I am a final year student in secondary education. |

|□ I have completed my secondary education. (Please read paragraph 7-C of the Application Guidelines carefully.) |

|I will take |□ the HKDSE Exams in 2021. |□ the IB Exams in 2021. |

| |□ the GCE Exams in 2021. |□ the Cambridge Pre-U Exams in 2021. |

| |□ other public examinations in 2021 (please specify: _____________________). |

|□ I am required to take a pre-interview assessment. I have been registered for it, and my candidate number is _________________(if |

|available). |

|□ I am not required to take a pre-interview assessment. (Please read Section 03 and paragraph 7-F (g) of the Application Guidelines |

|carefully.) |

|Check List (Please circle as appropriate) |

|I have attached the following to|Copy of HK Permanent Identity Card |Yes/No |

|this application. | | |

| |Copy of the UCAS application form |Yes/No |

| |Copy of the COPA form |Yes/No |

| |Copy of the SAQ form |Yes/No |

| |School Principal’s Confidential Report |Yes/No |

IMPORTANT NOTE: The final closing date for applications is Thursday, 15th October, 2020. Your application form, together with all the supporting papers, MUST reach The Friends of Cambridge University in Hong Kong Ltd on or before this date. (Please read paragraph 7-F of the Application Guidelines carefully.)

PLEASE PRINT CLEARLY IN BLOCK CAPITALS:

1. Applicant's name

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2. Gender

Male / Female (Delete as appropriate.)

3. Date of birth

Day Month Year

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Age on 1st October, 2021

................ years …......... months

4. Place and country of birth

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5. Home address

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Home telephone number

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Mobile Phone number

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6. Residence

(Please read paragraph 7-C of the Application Guidelines carefully.)

Do you hold a Hong Kong Permanent Identity Card?

YES / NO

State the years when you are/were resident in Hong Kong

from………to……….

7. Nationality

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8. Full names of parents* or guardians* (*Delete as appropriate.)

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Occupation of parents* or guardians* (*Delete as appropriate.)

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9. School currently attending

Name and full postal address

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Telephone number

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Fax number

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If you have left school, please indicate when you left and your present status:

(Please read paragraph 7-C of the Application Guidelines carefully.)

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10. Correspondence address

For term-time correspondence, please use:

HOME / SCHOOL* address

(*Delete as appropriate.)

11. Correspondence email address

(PLEASE PRINT CAREFULLY. This email account must be the same as the one shown on the front page of this form.)

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12. Educational institutions attended from age 11 to present*

(*please list in chronological order ALL such educational institutions attended)

|Name, Town and Country of schools (and grade attended) |Date entered |Date left |

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13. Examinations to be taken. (List ALL examinations you will take in 2021, and specify the subjects. Please tick and complete as appropriate.)

I ( will / ( will not take the HKDSE Exams in 2021.

I ( will / ( will not take the GCE Exams in 2021.

I ( will / ( will not take the IB Exams in 2021.

I ( will / ( will not take the Pre-U Exams in 2021.

I will not take any of the above examinations in 2021, but will take the following public examinations in 2021: (please specify)___________________________________________.

|Subject |Examinations |Specify level (e.g. A |Awarding Body/ |

|(If you are taking Combined Science in HKDSE, you|(Please specify whether |level or AS level in |Examination Board |

|should indicate the components, e.g. Comb.Sci. |HKDSE/GCE/IB/Pre-U Exams, and name such|GCE; HL or SL in IB, | |

|(Phys/Chem). For HKDSE Mathematics, please use |other public exams you are to take) |etc.) | |

|separate entries for Maths (Core), Maths (Ext | | | |

|Module 1) and Maths (Ext Module 2).) | | | |

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14. Examinations Taken To Date

(A) G.C.S.E. and similar examinations:

(Please tick and complete as appropriate. You must list the results of ALL public examinations which you have taken.)

|Subject |Awarding Body/Examination Board |Month and Year |Grade |

| | | |(for GCSE, state Grade |

| | | |and UMS Score/Out Of) |

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I ( have / ( have not taken any G.C.S.E. Examinations.

I was enrolled in the IB Middle Years Programme, and I ( have / ( have not been awarded an IB Middle Years Programme Certificate. (Attach a copy of your IB MYP Certificate, if any.)

(B) G.C.E. A or AS-Level, IB or similar examinations:

(Please tick and complete as appropriate. You must list the results of ALL examinations which you have taken.)

I ( have / ( have not taken any G.C.E. A-level or AS-level Examinations.

I ( have / ( have not taken any International Baccalaureate Diploma Examinations.

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|Subjects |Specify level |Awarding Body / Examination |Year |Results |

| |(e.g. A level or AS |Authority | |(GCE: State Grades and UMS (or |

| |level in GCE; HL or SL| | |raw, please specify) Score/Out |

| |in IB, etc.) | | |of; IB: State Score) |

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(C) Other Public Examinations:

(If you have sat any other public examinations like SAT, ACT or Advanced Placement Tests, you must list below the results of ALL such examinations which you have taken.)

( I have not taken any public examinations, except the ones stated above in this form.

( I have also taken the following public examinations:

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|Subjects |Specify level, where |Awarding Body / Examination |Year |Results |

| |relevant |Authority | |(State Grade or Score, as |

| | | | |appropriate) |

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(D) English Language Qualification

(Please tick and complete as appropriate. You must list the results of ALL IELTS which you have taken.)

I ( have / ( have not taken any International English Language Test (IELTS).

|Overall IELTS score |Reading Component |Listening Component |Writing Component |Speaking Component |Date taken |

| | | | | |(mm/yyyy) |

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|If you have taken a different English language qualification, other than those included in (A) and (B), please list all such English |

|language examinations below and provide details (including the name and date of the examination, your overall score and the score of each|

|component): |

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15. Should you be selected for interview, please state whether you will be in Hong Kong for the interviews (Please note that most applicants studying in Hong Kong will be interviewed in Hong Kong. Those who are currently studying in the U.K. or elsewhere in Europe are expected to attend interviews in Cambridge (see the next para). Please also read paragraph 7-G of the Application Guidelines carefully.)

YES / NO (state reasons) ………………..............................................................................

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16. Applicants who are studying in the U.K. or elsewhere in Europe may be asked to attend interviews at Cambridge. Please state if you will be able to attend such interviews.

YES / NO (state reasons) ………………………………………….……………….………

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17. Have you previously applied for the Prince Philip Scholarship? (If yes, please state which year and whether you were shortlisted for an interview.)

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18. Please list all other awards, scholarships, etc. for which you have applied or are intending to apply for your university studies, stating whether these applications have been successful (if known). (Please read paragraph 7-A of the Application Guidelines carefully.)

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19. Positions of responsibility held at school

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20. Extra-curricular Activities, Awards and Achievements, such as: Hong Kong Award for Young People, highest grades achieved in the Associated Board of the Royal Schools of Music examinations, awards in various national and international Olympiads and other competitions or contests.

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21. Interests and Hobbies

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22. Possible future career (if known)

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PERSONAL STATEMENT

Use some or all of the space on this page (but no more) to write a short account of why you wish to study your chosen degree subject, what you hope to achieve by doing so, and why you wish to come to Cambridge to do it. If your chosen university course is different from your present subjects, include a short statement about the ways in which you think your present subjects may be significant for your intended degree course. A type-written statement is acceptable.

Signature of applicant .................................................................. Date ....................................................................

Please describe below (but in no more than 2 pages) the 5 most significant activities or experiences you have engaged in or had. (They may be competitions, internships, charitable or other voluntary work, television programme watched, books read, etc.) You should explain why they are significant and what you have learnt from them.

DECLARATION BY THE APPLICANT

To: The Prince Philip Scholarship Selection Board

I, ___________________________, declare that all information appearing in this application form is true, up-to-date and complete, and to the best of my knowledge and belief, there is no other information or event which renders any of such information inaccurate or misleading. I am fully aware that the Prince Philip Scholarship Selection Board will rely on the information provided by me above in considering my scholarship application.

I also confirm that I have read the Application Guidelines for the Prince Philip Scholarship (including, without limitation, the Personal Information Collection statement of The Friends of Cambridge University in Hong Kong (“the Friends”) which is set out there). I acknowledge and agree that I will observe and abide by the terms and information set out of the Application Guidelines, and that the Prince Philip Scholarship Selection Board will only entertain my scholarship application on that basis.

Signature of applicant: ______________________________________

Date: _____________________________

Note:

Attach a copy of your Hong Kong Permanent Identity Card to this application.

(This page is to be completed by the applicant’s School Principal.)

CERTIFICATION BY SCHOOL PRINCIPAL

To: The Prince Philip Scholarship Selection Board

Name of Applicant: ______________________________________ (“Applicant”)

I certify that the information given in this form is, to the best of my knowledge and belief, correct and up-to-date.

I enclose a confidential report* by me or a teacher who has known the Applicant well for at least the past year.

In respect of an Applicant who will take the HKDSE Examinations, I also enclose the Applicant’s School Report for Secondary 4 to 6.

I support the Applicant’s application for a Prince Philip Scholarship for undergraduate studies at the University of Cambridge.

Signature ...................................................................................... Date .......................................

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NAME OF SCHOOL PRINCIPAL (IN BLOCK LETTERS)

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NAME OF SCHOOL (IN BLOCK LETTERS)

*Important Note: Please read carefully the “Guidelines For Writing School Principal’s Confidential Report” printed overleaf. The format of the School Principal’s Confidential Report is available at: .hk/resources

UNIVERSITY OF CAMBRIDGE

THE PRINCE PHILIP SCHOLARSHIP

GUIDELINES FOR WRITING SCHOOL PRINCIPAL’S CONFIDENTIAL REPORT

In writing the report, please adopt the format appearing at: .hk/resources

It would be helpful to the Selection Board if you could provide us with as full a report on the applicant as possible. In particular, please provide the Selection Board with your detailed comments under each of the headings (A to F) listed in the proforma report which you can download from the website mentioned above -- your detailed comments on these aspects of the applicant’s performance and potential are very important to us in the selection process.

Updated 13/8/2020

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