COURSE OF STUDY WHICH THE APPLICANT INTENDS TO FOLLOW
Title of course …………………………….……………………………………
Academic award sought …………………………………….
Length of course ……………………………..
Mode of attendance, e.g. part-time, full time or other ……………………………
Duration of support requested …………………………………
Please submit two references, one of which should be from the school where you were educated,
and one from an employer or other person not related to you.
Give brief reasons (up to 100 words) why you wish to pursue this line of study, what other resources
you have access to, and what other action you have taken to secure funding
Endorsement of the proposed academic institution must be attached to this
form. Applications will not be considered if this requirement is not met.
See form of certificate on following page.