Application Form – Djihanian-Teshkhoian Foundation

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TO BE COMPLETED BY THE APPLICANT

NAME

First

Last

DATE OF BIRTH

ADDRESS

Address Line 1

City

State / Province / Region

Postal Code

Country

KINDLY UPLOAD YOUR PICTURE

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WHICH COUNTRY(IES) ARE YOU A CITIZEN OF?

Confirm Email

HOME PHONE

CELL PHONE

HAVE YOU GRADUATED FROM THE HIGH SCHOOL?

YES
NOT YET

WHICH UNIVERSITY ARE YOU GOING TO STUDY AT?

PLANNED FIELD OF STUDY

WHERE DO YOU PLAN TO LIVE DURING THE ACADEMIC YEAR?

NAME ANY AID OR GRANTS YOU ARE OR WOULD BE RECEIVING

HOW LARGE OF A SCHOLARSHIP WOULD YOU NEED TO COVER YOUR TUITION FEES?

50%
75%
100%

IN APPROXIMATELY 500 WORDS, TELL US WHY YOU SHOULD RECEIVE THE SCHOLARSHIP?

KINDLY LIST YOUR SOCIAL MEDIA ACCOUNTS

HOW DID YOU LEARN ABOUT THE DJIHANIAN SCHOLARSHIP INITIATIVE?

KINDLY UPLOAD YOUR CV HERE

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KINDLY UPLOAD YOUR REFERENCES

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I HEREBY SUBMIT MY APPLICATION FOR A DJIHANIAN SCHOLARSHIP. IN SO DOING, I ATTEST TO THE VERACITY OF THE INFORMATION PROVIDED. I UNDERSTAND THAT IF APPROVED, THE SCHOLARSHIP WILL BE TRANSFERRED DIRECTLY TO THE ACADEMIC INSTITUTION AND WILL BE AWARDED FOR ONE (1) ACADEMIC YEAR. I FURTHER UNDERSTAND THAT RENEWAL FOR FUTURE YEARS IS CONDITIONAL UPON MAINTAINING SATISFACTORY ACADEMIC RESULTS. I CONSENT TO RESIDE IN ARMENIA FOR A MINIMUM OF FIVE YEARS FOLLOWING MY GRADUATION. I ACKNOWLEDGE THAT A BREACH OF THIS CONDITION WILL RESULT IN THE OBLIGATION TO REPAY THE SCHOLARSHIP FUNDS RECEIVED.

Clear Signature

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TO BE COMPLETED BY THE APPLICANT

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