African Science Academy - Scholarship Application Form 2019
Eligibility: female students with academic excellence, able to demonstrate clear need for financial assistance.
Please answer all questions.

Please make sure that you have completed the ASA Application form before completing this scholarship form. Scholarship applications will only be considered if the applicant has also completed the standard school application. This is the school application
form:https://docs.google.com/forms/d/e/1FAIpQLScx99_VhsQGCVdMUj_O_VtAKsxq1zMNmBw_azwzvboO6230iA/viewform

For more information please visit our website at: www.africangifted.org or contact us on admissions@africangifted.org

Email address *
Applicants Name *
Your answer
Applicants Phone Number (please include your country dialling code) *
Your answer
Applicants Email Address *
Your answer
Who do you stay with?
If you stay with a guardian or someone else, please specify your relation to them
Your answer
Indicate state/condition of mother
Indicate state/ condition of father
How many siblings do you have?
Your answer
What is the total number of children under 18 in your household? (those taken care of by the same parent or guardian)
Your answer
Is your parent/ guardian
If employed is your parent/guardian
If employed, is your parent/guardian working
What is your father’s profession?
Your answer
How much does your father earn per month? (specify the currency)
Your answer
What is your father’s highest level of education/degree attained?
Your answer
What is your mother’s profession?
Your answer
How much does your mother earn per month? (specify the currency)
Your answer
What is your mother’s highest level of education/degree attained?
Your answer
What is your guardian’s profession (if living with guardian)?
Your answer
How much does your guardian earn per month (specify the currency) (if living with a guardian)?
Your answer
What is your guardian’s highest level of education/degree attained (if living with a guardian)?
Your answer
Who else contributes to your household (e.g. older sibling or extended family)? How much do they contribute approximately per month (specify the currency)?
Your answer
Please list any other sources of household income, in order of importance, such as, rental income, transfer of income from outside the household, etc. and please describe the amount per month (specify the currency)
Your answer
Who is providing your basic needs?
Your answer
Who is paying the cost of your education?
Your answer
Are you currently on a scholarship (if yes, please provide details)?
Your answer
What is the amount of your current school fees for one academic year (inclusive of all top-up fees and levies and boarding fees) (specify currency)?
Your answer
Have you or your siblings ever missed a significant part of a school term because of finances (if yes, please provide details)?
Your answer
How much money do you spend on average per day at home?
Your answer
Please describe the monthly household expenses. Examples: rent/mortgage, electricity, telephone, medical expenses, school fees, food, etc (please specify approximate amounts and specify the currency).
Your answer
Does anyone who lives with you have a disability or chronic/fatal illness/disease (if yes, what is your relationship to the person and what illness or disability do they have)?
Your answer
What is the main source of energy (light) in your house?
Does your family/guardian benefit from any poverty reduction programme or food rationing (if yes, please provide details)?
Your answer
Do you have a passport (If you have a passport, please describe below when, where, and why you have used it. Note that not having a passport does not preclude eligibility for a scholarship with ASA)?
Your answer
Where do you have access to the internet?
Your answer
Why do you need this scholarship to attend our school (please be as detailed as possible)?
Your answer
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