SCHOLARSHIP APPLICATION
1
PERSONAL INFORMATION
Name
Date and Place of Birth
Address
Phone
Gender
Marital Status
ID Number
Nationality
Religion
Tax Number
Email Address
Language Proficiency
Language
Speaking
Reading
Writing
Listening
2
FAMILY INFORMATION
Father's Name
Occupation
Monthly Income
Address
Mother's Name
Occupation
Monthly Income
Address
Number of Siblings
3
EDUCATIONAL INFORMATION
Name of University
Date of Attendance
Date of Graduation
Program Attended
Cumulative GPA
List of the most significant extraculicular and community activities (sport, art, music, social or public service, etc) in your university



4
WORKING INFORMATION
Do you have working experince ?
1.
2.
3.
5
ACHIEVEMENTS INFORMATION
Have you ever recieved certification of achievement
*If yes describe



Are you in receipt of any other scholarship
*If yes describe
In what specific ways will you use Obor scholarship opportunity to influence the country you stay after graduation ?
How will you growth as a leader directly benefit other ?
Please describe your past/present organization experiences and services involvement



6
SCHOLARSHIP PROGRAM APPLYING
Planned program of study
Majors of study
Name of university you planned on attending
Specify the name of the person who can give recommendation for you
7
DOCUMENT UPLOADS
ID Card / NIK (*jpg)
Tax Number /NPWP (*jpg)
School Certificate (*jpg)
Transcript (*jpg)
Spt PPh 21 (*jpg)
Recent Photograph 4x6 (*jpg)
8
PLEASE READ AND SIGN THE FOLLOWING STATEMENT
I understand that if any of the above statement are proven false,
The scholarship will be denied / cancelled.
Also if I do not complete each semester of year successfully, my scholarship will be cancelled. I certify all information contained herein is true and complete to the best of my knowledge and belief.
Disagree