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CLOSING DATE: 30th January 2013 IMPORTANT INFORMATION 1. 2. 3. 4. 5. 6. 7. The scholarship is awarded to Malaysian students who intend to pursue full-time undergraduate studies (1st degree course) tenable at recognized universities in Malaysia or abroad. Students who have completed their STPM/A-Level/Foundation Year/Diploma or currently in their final semester of Matriculation studies are eligible to apply. Please complete the form digitally. Incomplete and late application will be rejected. If you do not receive any reply from us by 30 April 2013, your application is therefore considered unsuccessful. *Please delete whichever is NOT applicable. This Scholarship Application Form should be submitted online via the Shell Malaysia Online Application website on www.shell.com/my - Jobs & Careers - Students & Graduates Scholarship.
CHOICE OF STUDY Choose (one) either Overseas or Local Scholarship only. Not allowed to apply for both Overseas and Local. a) Overseas Technical: Petroleum Engineering Geosciences Mechanical Engineering Civil Engineering Electrical Engineering
Others: __________________ (Specify) Commercial Role: _________________ (Specify) At which university? ___________________________ (Specify)
b) Local (Malaysia) Technical: Petroleum Engineering Geosciences Mechanical Engineering Civil Engineering Electrical Engineering
Others: __________________ (Specify) Commercial Role: _________________ (Specify) At which university? ___________________________ (Specify) WHY HAVE YOU CHOSEN THIS CHOICE OF STUDY? Make a brief statement, of not more than 200 words, of your choice as they relate to your aspirations, career objectives and long term goals.
1.
PERSONAL PARTICULARS
(as per your MyKad)
Name
NRIC No. Age: State of origin : Peninsular Malaysia/Sarawak/Sabah Combined Family income (in RM per month) Family Income statement (Are there any unusual family circumstances you want considered as part of your application? Max 100 words)
2. ACADEMIC RESULTS Please state your specific academic subjects plus exact grade (A+, A-, C+ etc) from STPM/A-level onwards to the highest level of study achieved to date
ACTIVITIES
e.g. - Interact Club Swimming
REPRESENTED
e.g. - National
House; School; District; Division; State; National Chairman; President; Vice/Dep. President/Chairman; Captain/Leader; Treasurer; School Prefect;
GRANTED/SPONSORED BY
5. OTHER FINANCIAL INFORMATION Are you currently receiving any financial assistance or sponsorship from other institution, fund or foundation? YES/NO* If YES, please give details: Institution/Fund/Organization/Foundation (e.g. JPA, MARA, PETRONAS, PTPTN, Year Amount (RM) etc.) 1) 2) 3) 6. RECOMMENDER Provide name and contact information of a teacher, counselor, instructor or work supervisor Name: Role: Contact info:
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