African Science Academy - Application Form 2019
Email address *
PERSONAL INFROMATION
The African Science Academy is now recruiting for students for the academic year starting in August 2018. We welcome applications from girls from across Africa, typically aged 16 years or older, who have completed their Senior Secondary School Certification, iGCSEs, O Levels or equivalent. Applications must have a passion for maths and science. Amongst the subjects studied at senior secondary school, applicants must have achieved impressive grades in Maths and Physics. To find out more, please visit our website www.africanscienceacademy.org or email us on admissions@africangifted.org.
Please enter your name and all information as it appears on official documents, such as, an identification card, birth certificate, or passport.

You can also apply for a scholarship with ASA here
https://docs.google.com/forms/d/e/1FAIpQLSd9UudN4xy4vavsVSNMxoPqn8FRfuFWlyQYahbzFc3myTyI3Q/viewform. If you would like to be considered for a scholarship, please complete the scholarship form in addition to this standard application form. You must complete BOTH forms to be considered for a scholarship.

Legal Last Name *
Last Name (if different)
First Name *
Middle Name(s)
Date of Birth *
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Citizenship *
Primary Language spoken *
Other Languages spoken
CONTACT INFORMATION
Street
Town/City *
Region
Email Address *
Contact Number (please include the country dialling code) *
Alternative Number *
Please upload a recent passport style photo of yourself
FAMILY INFORMATION
Father's Name *
Is your Father your: *
Father's employer
Father's employer telephone number
Father's telephone number *
Mother's Name *
Mother's Maiden Name
Is your mother your: *
Mother's employer
Mother's employer telephone number
Mother's telephone number *
STUDENT EDUCATIONAL BACKGROUND
If you are currently still at school, then please, include your current course and expected graduation date.
Highest Level of Education completed and Date completed (dd/mm/yy) (Example: Accra SHS 09/06/2016) *
Senior High School - Name of Institute and Dates attended (dd/mm/yy)
Junior High School - Name of Institute and Dates attended (dd/mm/yy)
List any other school attended and what course completed
Please, list any additional qualifications, awards and certificates (e.g. in music or sport)
Please upload your most recent national examination certificate, such as O-Levels, BECE, or WASSCE results.
Please upload your school reports from the last 6 terms. Please save these all as one pdf and upload them all as one.
ADDITIONAL INFORMATION
Please, provide as much detail as possible
How did you learn about African Science Academy?
Why do you want to become a student at our school?
What special skills and talents would you bring to our school?
Are you engaged in any extra-curricular activities (e.g. sports, community service or music)? If yes, provide details.
Why are you passionate about Maths and Science?
Please write any additional information not conveyed in this form that will strengthen your application.
REFERENCES & COMPLETION OF APPLICATION
Your application will only be valid once we have received a recommendation from your headteacher or classteacher and once your parents have given permission for you to apply to our school
Reference
Please select a teacher or school official who will provide a recommendation validating the information provided in this application and providing us with predicted school results. Please provide the person’s name, mailing address, e-mail address, and phone number. Please indicate your relationship to this person.
Name *
Phone number *
E-mail address
Relationship *
Additional Documents Required
In order for your application to be complete, you need to submit a recent passport style photo and your transcripts from the last 6 terms. In addition, we require certificates from the applicants latest national exam, such as O-Level or BECE or equivalent. If the applicant has finished school, they need to provide us with their school leaving certificate. Your application will not be considered without these documents. These can be uploaded directly onto this form or sent to us via email at admissions@africangifted.org
Parent information
Your parents will also be contacted to validate the information provided and to give their permission for you to apply to our school. Please provide us with their name, phone number and email address.
Parent's Name *
Parent's Phone Number *
e-mail address
APPLICATION STATEMENT
I certify that the answers I have given in this application are true and complete to the best of my knowledge. I acknowledge that misinterpretation or omission may be the cause for my rejection as a student at the school or subsequent dismissal from school if discovered after acceptance.
All information will be kept in strict confidence and will be used by appropriate authorities for the purposes of admissions into the African Science Academy. I authorize the release and use of this information, as described above, to my reference, parents, African Science Academy admissions team and other employees and partners working with the African Science Academy to evaluate the applications.
Student Signature - type name (by signing you agree to the Application statement above) *
Date application statement signed *
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A copy of your responses will be emailed to the address you provided.
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