1
FLORENCE NKRUMAH ONNY SCHOLARSHIP FUND
APPLICATION FORM
For GTUC continuing students only
Please type or print your answers. If application is illegible it will be returned to you.
1.
Last Name:
First Name:
2.
Address of Applicant:
3.
Daytime Telephone Number:
4.
Date of Birth: Month Day Year
5.
Programme Pursued at GTUC:
Current Level:
6.
Courses to be enrolled or registered for ensuing / next academic year
Course Details (September) Course Details (January)
: _____________________________________ _____________________________________
: _____________________________________ _____________________________________
: ___________________________________ ___________________________________
: ___________________________________ ____________________________________
: ___________________________________ ____________________________________
: ___________________________________ ____________________________________
Proof of acceptance or current student enrollment is required prior to receipt of funds.
7.
Prior Entry qualification results (e.g. W.A.S.S.C.E and other entry qualifications to be attached)
Proof of student’s results will be required.
8.
Cumulative Weighted Average (CWA): __________ (On a scale of 1.00 -100.00)
Kindly attach proof of CWA. Your most recent official school transcript required.
9.
Name & mailing address of father / guardian (if applicable): Phone Number
Name (s)
10.
List expenses you expect to incur this semester (Approximate figures acceptable)
Tuition: Amount: Gh¢ C. Room & Board Amount: GH¢
Books: Amount: Gh¢ D. Other Expenses Amount: GH¢
11.
List income that you expect to receive from other sources this semester: (Approximate figures
acceptable)
A
Personal: Amount: Gh¢ C. Student Loan(s) Amount: GH¢
B.
Other Scholarship(s): Amount: Gh¢ D. Other Financial Sources Amount: GH¢
12.
What are your educational and professional goals and objectives?
2
13.
List your academic honours, awards and club membership activities at GTUC:
-
-
-
14.
List your community service activities, hobbies, outside interests, and extracurricular activities:
-
-
-
-
15.
A. The following items must be attached to this application in order for the application to qualify to be
considered by the scholarship committee.
B. Your application will be returned to you if these items are not attached to this application. (No
exceptions.)
C. Circle “YES” or “NO” to be sure you have attached each item as required.
YES
NO
Three (3) reference forms. Return these completed forms in a sealed envelope from your
nominated referees.
YES
NO
Proof of current student enrollment. Registration, tuition or hostel payment could be used to
satisfy these criteria.
YES
NO
Most recent official academic transcript. Photocopies of your transcript are not acceptable,
unless they are certified and stamped by the issuing authority.
STATEMENT OF ACCURACY
I hereby affirm that all the above stated information provided by me is true and correct to the best of my knowledge. I
also consent that my picture may be taken and used for any purpose deemed necessary to promote the Scholarship
Fund (?).
Signature of scholarship applicant: _________________________________ Date: _______________________
Submit to:
The Florence Nkrumah Onny Scholarship Fund
Office of the President
Ghana Technology University College
Private Mail Bag 100,
Tesano.
Accra
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Office Use Only - Please tick to indicate which of the following requirement have been complied with:
Requirements / Criteria
Yes
No
1.
Is the applicant applying for the first time?
2.
Have passport pictures provided been endorsed?
3
Has the applicant provided all needed documentary evidence or proof of qualification criteria as
expected e.g. transcripts and certificates?
4
Has the applicant been offered admission to offer the programme?
5
Is the applicant’s current grade within the limit required?
Remarks/Recommendations by Representative of Scholarship Committee
________________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________
Recommended For Scholarship [ ] Not Recommended For Scholarship [ ]
Name Signature Date
______________________ _______________________ ___________________