The British Chevening

Scholarships

Photograph

Application form
Please complete all parts of this form in black ink or typescript and attach a recent photograph of yourself in the above space.
DO NOT attach CVs or resumes in lieu of completing Parts A, B or C below. Incomplete forms will not be accepted. Please
return completed form with attachments to the Scholarships Officer (Chevening) at the address below.

PART A: PERSONAL DETAILS

Family name (as on passport):
Given names
Title:

Mr

Mrs

Miss

Ms

Dr

Sex:

Place of birth (town and state):

Male

Female

Date of birth:

Nationality:
Status

Single

Married

Divorced

Widowed

Number of children (if applicable)

Will any member of your family accompany you to the UK? If so, please specify which ones and state how you propose to
meet their expenses. Under the British Chevening Scholarships programme we cannot pay partner or child allowances: any
stipend you receive is intended to cover your expenses only.

Address for correspondence in home country

Home telephone

Office telephone

Home fax

Office fax

E-mail address

Pager/mobile

Name, address and telephone number of next of kin or person who should be contacted in the event of an emergency
(please state relationship)

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British Embassy Bucharest

The British Council

Calea Dorobantilor 14
Bucharest 71132
Romania
Tel: +40 (1) 3104140, 2100314
Fax: +40 (1) 2100310
Email: bc.romania@britishcouncil.ro
Website:http:// www.britishcouncil.ro

Where are you currently working or studying?

If you are currently working, please provide brief details of your post, grade and main responsibilities

If you are currently studying, what qualification do you expect to obtain, and when do you expect to obtain it?

PART B: ACADEMIC BACKGROUND

i)

Please list all academic qualifications obtained since completing your secondary education, stating the institutions
attended, the main subjects of study, the grade or classmark you achieved and when the main courses started
and finished. Please indicate with an asterisk those courses which were entirely or mainly English medium.

Qualification
(including class or level)

Institution

Subject

From

To

Please attach A4 photocopies of all relevant academic certificates or transcripts with accompanying translation into English, if they
are written in another language. Applications will be considered incomplete if certificates or transcripts are not attached.
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PART C: PROFESSIONAL BACKGROUND/ CAREER HISTORY

Please list positions held since completing your secondary or tertiary education

Position

Organization/ Institution

From

To

PART D: EXTRA CURRICULAR ACTIVITIES

Please give details of any interests or activities that you pursue outside your studies or professional work. You should also
indicate any positions of responsibility that you have held relating to these hobbies, sporting activities, community work, etc.

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PART E: BRITISH CHEVENING POSTGRADUATE SCHOLARSHIPS

What qualification would you like to obtain, in what subject, and at which institution(s)? If there are alternatives to your first
choice, please state order of preference. If you wish to conduct research rather than obtain a formal qualification, please
state so clearly, and indicate when you intend to start, and for how long your research will last.

Qualification and Course Title

Institution

1.

2.

3.
Have you already been in contact with the institution(s) of your choice?
Yes
No
If so, please attach photocopies of all relevant correspondence (e.g. acknowledgements of applications and offer letters)

PART F: PREVIOUS CONTACT WITH THE UK

Have you ever studied in the UK?
If you answer Yes, please give full details.

Yes

No

Were you in receipt of a British Government funded award or scholarship?

If yes, please give full details.

Yes

No

Have you ever visited the UK on holiday or for other purpose?

If so, please indicate when and what the purpose of your visit was.

Yes

No

Are you applying for any other scholarships or awards to study in the UK
Yes
to be funded either by the British Government or by other institutions or foundations?
If so, please give full details.

No

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PART G: PROFESSIONAL AND/OR ACADEMIC REFERENCES

Please attach letters from two referees (both of whom should be professional or academic) in support of your application for
a British Chevening Scholarship. Please provide details of the two referees below. If you are unable to attach letters from your
referees, please ask them to write us. Applications will only be accepted if accompanied by two confidential reference letters.
FirstReferee
Title and name
Position
Address
How long have you known this referee?
What is his/her professional relationship to you?
SecondReferee
Title and name
Position
Address
How long have you known this referee?
What is his/ her professional relationship to you?

PART H: PERSONAL STATEMENT

Finally, please state in not more than 1,000 words in the space provided below (or attach separate sheet).
a) why you wish to study in the UK
b) why you wish to obtain the qualification listed as your first choice above, and
c) how you think you will benefit in terms of your career and personal development from obtaining this scholarship and the
resulting qualification once you have returned to your home country.
Please also give full details of any particular areas in which you would like to concentrate as part of your course of study or
research while in the UK.
Once completed, sign and date the form overleaf and return it to: The British Council, Calea Dorobantilor 14, Bucharest 71132,
Romania.

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P.T.O

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Signature
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Date