Late Emmanuel Idowu and Maira Ajike Areogun Scholarship Foundation

INSTRUCTION

Please fill in the following application form completely and attach all information and documents required. Academic reference from applicant’s HOD/Course Advisor New students must attach UTME & post – UTME score slips and admission letter Returning students must attach admission letter, credentials, and up-to-date academic transcript duly signed by the head of your institution or his representative Check Session 10 for other supporting document required

INCOMPLETE APPLICATION WILL BE REJECTED!

Surname/Family Name

Fornames/Given Names

Date of Birth

Country

State of Origin

Gender

Male Female

Identification Means

International Passport Drivers licence National ID Card University ID

Passport Number

CONTACT DETAILS

Street and Number

City

CORRESPONDING DETAILS

Name and Address of Parents (Include phone no and email if available)

Parental Status

Together Seperated Divorced

Are they both alive?

Yes NO

Please indicate if any of them is late

Parents Occupation (Please indicate if they are retired or unemployed)

What is your no in the family?

Do you have siblings who are also in school?

Yes No

(If yes, please indicate no, schools and stages in school)

Are you presently working/ or engaged in any income generating activity?

Yes No

(if yes) Please give a brief detail of the work/Income-generating activity

Do you have dependants (people you are financially responsible for)?

Yes No

If yes, please explain the circumstances that led to it.

Are you born- again?

Yes No

If yes, briefly describe your salvation experience

What is the Name of your church?

When did you join the church?

Details of your Pastor

Primary School Attended

Secondary School Attended

Have you secured admission to any institution of higher learning in Nigeria?

Yes No

If yes, please indicate the school, your department and level. Attach your UTME and post – UTME score slips and admission letter

Department

Level

UTME Score Slip

Post UTME Score Slip

Admission Letter

Are you currently admitted into any institution of higher learning in Nigeria

Yes No

If yes, please indicate the school, your department and level. Attach your admission letter, credentials, and up-to-date academic transcript duly signed by the head of your institution or his representative

Department

Level

Admission Letter

Academic Transcript

Other Credentials

No of years expected to spend in school:

No of years currently spent in school:

Degree In-view

Bachelor HND OND

Others, Kindly Specify

Class of Last Academic Result

GPA

CGPA

Expected date of Graduation (YY/MM/DD)

List of Academic Award/Prize

Career Objectives in the Next % 5years

What are your Long Career Plans?

Have you benefited from this scholarship before?

Yes No

If yes, give details:

Personal Statement (Why you should be offered this scholarship)

Supporting Document
1. Passport Photo
2. Photocopy of ID
3. Academic certificates (WAEC, ND, HND)
4. UTME result slip, Post-UTME result slip and Letter of admission into institution of higher learning in Nigeria
5. Evidence of registration for past sessions (applicable to returning students)
6. Academic reports/transcript for past sessions (applicable to returning students)
7. Academic reference letter from your HOD / Course Advisor
8. Letter of support from local church Pastor
9. Letter of commitment to sound academic pursuit and continual followership of Jesus Christ by the student if given the scholarship. (Failure to uphold that will result in the withdrawal of the scholarship)
10. Photocopy of School ID for returning students

I hereby declare that all information supplied in this form is true to the best of my knowledge. I agree to forfeit this scholarship – if given – should it be discovered that I had deliberately supplied any false information. I also agree that the scholarship is a privilege and not a right and so will abide by the decision of the foundation board with respect to my application and accept the same in good faith.

Signature

Date