2014 uwc vietnam appli form

8/10/2019 2014 UWC Vietnam Appli Form

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APPLICATION FORMUNITED WORLD COLLEGES SCHOLARSHIP PROGRAM

VIETNAM 2014 INTAKE

BẢN ĐĂNG KÝCHƯ NG TR!NH H"C B#NG C$C TRƯ%NG TH& GI'I LI(N K&TK! TU)*N CH"N T+I VI,T NAM NĂM 2014

PART 1 - ./ /3 5 . 6 7 .8 9 5: 9;.PH<N 1 = 6/ .8> ?:;8 8/@; .8: ;

1. Full name/Họ và tên: ..................................................................................................(in capital letters, Vietnamese name order, with full Vietnamese accents/Vi t ch! hoa, c" #$ d%u, theo th& t' tên n )*i Vi+t

Female/-!: ale/-am: ate of 0irth/- à sinh: .................................2. Home mailin address/34a ch5 6i th): ..........................................................................

(in Vietnamese/07n ti n Vi+t...............................................................................................................................

8it 9province/ 5nh9thành ph;: .....................................................................................Home telephone/3i+n tho<i ia #=nh: ............................... ............................................>ther phone (if applica0le /3i+n tho<i ?h@c (n u c" : .....................................................A9mail: ...... .................................................................. ............................................(in capital letters/Vi t ch! hoa

B. Cresent school/ r)*n #an theo học: ..........................................................................Dchool name in Vietnamese/ ên tr)*n 07n ti n Vi+t: .................................................................................................................................................................................

ate of Ettendance/ h*i #i m 0Gt # u theo học: ............................................................Eddress/34a ch5: .........................................................................................................8it 9province/ 5nh9thành ph;: .....................................................................................Head of school/Hi+u tr)In : ........................................................................................

elephone/3i+n tho<i: .................................................................................................

A 5: 9;. ? ?.9. 3 ;. ;8 ; 9 .8> ?:;8

I certify that the information given in this application is complete, authentic and accurate tothe best of my knowledge. If awarded the scholarship, I agree to comply with any necessaryregulations set by the United World College and to contribute to and support UWC Vietnam to

the best of my ability.T i !"c nh#n l$ nh%ng g& t i '(a ra trong b)n '*ng k+ n$y l$ ' y '- v$ ' ng s/ th#t. 01u'(2c trao h3c b4ng, t i '5ng + tu6n theo c"c 7uy '8nh c-a Tr(9ng Th1 gi:i ;i<n k1t m$ t i'(2c ch3n= v$ cam k1t s> '?ng g?p v$ h@ tr2 h1t sAc m&nh cho hoBt ' ng c-a UWC ViDt 0am.

EpplicantJs Di nature/8h! ?K c$a thL sinh: ..........................................................................

ate/- à : .....................................................................................................................



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PART 2 = ./ /3 5 . 6 7 .8 9 5: 9;. ? 9 ;.?PH<N 2 = 6/ 89 3J .8> ?:;8 8/@; .8: ;

hese Nuestions are for internal use of the selection process onl and will not 0e shared withan eOternal a enc . he are treated as confidential information.

-h!n cPu hQi sau #P ch5 dành cho nRi 0R tron Nu@ tr=nh tu n chọn và sS ?hTn #)Uc chias #;i vWi 0%t ?= c@ nhPn ha tX ch&c 0ên n oài nào. -h!n thTn tin nà sS #)Uc O6 lK nh)thTn tin mYt.

FAMIL) INFORMATION TH NG TIN V GIA Đ!NH1. -ame of other/Họ tên Z: .........................................................................................

8ontact num0er(s /3i+n tho<i liên h+: ..........................................................................Amail: ......................................................................................................................>ccupation/- h[ n hi+p: ............................................................................................Amplo er/3\n v4 cTn t@c: .........................................................................................Cosition/8h&c v]: .......................................................................................................

2. -ame of Father/Họ tên 8ha: ........................................................................................8ontact num0er(s /3i+n tho<i liên h+: ..........................................................................Amail: ......................................................................................................................>ccupation/- h[ n hi+p: ............................................................................................Amplo er/3\n v4 cTn t@c: .........................................................................................Cosition/8h&c v]: .......................................................................................................

B. arital status of parents/ =nh tr<n hTn nhPn c$a cha mZ

arried/^ t hTnDeparated9 ivorced/_ thPn9l hTn

other livin , father deceased/ Z c`n s;n , 0; # m%tFather livin , mother deceased/b; c`n s;n , mZ # m%tDin le parent/b;9mZ #\n thPn>ther (eOplain /^h@c ( hi c] th ............................................................................

M. How man si0lin s does the applicant have / hL sinh c" 0ao nhiêu anh ch4 em ...............

. Has an mem0er of our famil attended a 8 gf es, please ive details.8" thành viên nào c$a ia #=nh t n theo học t<i mRt r)*n h iWi _iên ? t ?hTn - uc", h cun c%p thêm chi ti t.-o/^hTn es/8"-ame of 8 scholar/ ên học sinh 8 tron ia #=nh: ................................................-ame of 8/ ên r)*n h iWi _iên ? t: ..................................................................

ime of stud / h*i ian theo học: ...............................................................................



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j. Clease ive a 0rief summar of an medical pro0lems, serious illness, hospitalikation oraller ies the applicant ma have had in the past or is havin .H nêu vGn tGt 0%t c& mRt v%n #[ nào v[ s&c ?hQe, 0+nh tYt, n7m vi+n ho c d4 &n nàomà thL sinh # ho c #an mGc ph i.................................................................................................................................................................................................................................................................................................................................................................................................

. gs there an food that the applicant can not or does not eat Clease ive a reason (reli ion,aller or personal choice .8" lo<i th&c n nào mà thL sinh ?hTn th n #)Uc ho c ?hTn n ?hTn H nêu lK do(do tTn i@o, d4 &n ho c sI thLch c@ nhPn................................................................................................................................................................................................................................................................................................................................................................................................

FINANCIAL DECLARATION K( KHAI T I CH NH

Famil Js com0ined annual income D ...........................hu nhYp h7n n m c$a ia #=nh (c cha và mZ

Davin s D ...........................i[n ti t ?i+m

Value of investment/Dhares/Dtoc? D ...........................qi@ tr4 c@c ?ho n # u t)/8X phi u/8h&n ?ho@n

Value of famil Js propert D ...........................qi@ tr4 nhà #%t c$a ia #=nh

Value of other 8apital D ..........................qi@ tr4 c@c tài s n ?h@c

-um0er of motor0i?es 0elon in to the famil .................................D; l)Un Oe m@ c$a ia #=nh

brand of motor0i?es(s / h)\n hi+u: ......................................................................

oes the famil own a car gf es, please provide the num0er of cars and its/their 0rand(s .qia #=nh c" sI h!u Oe h\i ?hTn H cho 0i t s; l)Un và th)\n hi+u tron tr)*n hUp c".

-o/^hTn es/8" -um0er of car(s .........................................................brand of car(s / h)\n hi+u: ..................................................................................

-um0er of people in the famil that depend on the parentsJ income. .................................D; l)Un thành viên tron ia #=nh ph] thuRc vào thu nhYp c$a 0; mZ.

oes the famil emplo other peopleqia #=nh c" tu n d]n n )*i làm ?hTn

-o/^hTn es/8"

gf es, how man in the home /- u c", 0ao nhiêu n )*i tron ia #=nh ......................gn the famil 0usiness/bao nhiêu n )*i tron doanh n hi+p/cTn t c$a ia #=nh .........



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How much mone does our famil owe to other people or to financial institutions ................D; ti[n mà ia #=nh c`n nU c@ nhPn ho c tX ch&c tài chLnh

eason for de0t/_K do c$a vi+c nU: .........................................................................id the famil have or is havin an ma or irre ular eOpenses (such as ma or medical costs,

additiontal educational spendin , etc Clease specif .qia #=nh # ho c #an c" chi phL 0%t th)*n lWn nào ?hTn (vL d] chi phL t lWn, i@o d]cph@t sinh, v.v... H nêu r .....................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................

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CONTRIBUTION ESTIMATE D TR NGQN S$CH CHO TH SINH THEO H"C T+I UWC

Astimate mount of mone the famil contri0ute to the cover the eOpenses relatin to theapplicantJs studies at a nited orld 8olle es if selected, in addition to eOpense for visa,travels, and poc?et mone .

' tLnh s; ti[n ia #=nh c" th d n # chi tr cho c@c chi phL liên Nuan # n vi+c thL sinh theohọc t<i mRt r)*n h iWi _iên ? t n u #)Uc chọn, n oài c@c chi phL liên Nuan # n vi+c Oin th4th'c, chi phL #i l<i, và chi phL tiêu v t.

D ..............................................................................................................................

ACKNOWLEDGEMENT $C NH N

g have read this application prepared 0 m dau hter/son and it has 0een made with m full?nowled e and approval. he facts iven are, to the 0est of m ?nowled e, true and accurate.

hile m dau hter/son is in residence at a nited orld 8olle e, g wish and authorike the8olle e to act as quardian in m place for decisions involvin her/his personal care andwelfare. g certif the information a0out m famil Js financial statement is true, correct and complete.

Ti # #ọc h s\ # n ?K nà do con tTi chuxn 04 và n" # #)Uc làm vWi t%t c s' hi u 0i t và# n K c$a tTi. -h!n thTn tin #)Uc vi t ra, theo hi u 0i t c$a tTi, là #yn và O@c thYt.

ron th*i ian con tTi s;n t<i r)*n h iWi _iên ? t, tTi mon mu;n và $ Nu [n chor)*n tha th tTi tron c@c Nu t #4nh liên Nuan # n ch m s"c và phyc lUi c$a [email protected] O@c nhYn nh!n thTn tin v[ tài chLnh I trên là thYt, #yn và # #$.

Di nature of father/8h! ?K c$a cha: . ate/- à : ................................

-ame/ ên: .. ..........................................................................

Di nature of mother/8h! ?K c$a mZ: . ate/- à : ...............................

-ame/ ên: .. ..........................................................................



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PART ./ /3 5 . 6 7 .8 9 5: 9;.PH<N 6/ .8> ?:;8 8/@; .8: ;

SCHOLARSHIPS FOR VIETNAM H"C B#NG D NH RI(NG CHO VI,T NAM

Clease note that our application is to the nited orld 8olle es s stem. 8 Vietnam, 0asedon our financial needs, will ma?e the final dicision on which 8 we send ou as ournominee. he selection process will 0e 0oth merit90ased and needs 0ased. Full scholarshipsshould 0e iven to students who trul need them in order to attend the school. Cartialscholarships and placements without fundin should 0e iven to students who can afford all orparts of the eOpenses. Epplications for full scholarships, partial scholarships and placementswithout fundin will 0e treated separatel .

For all t pes of offers, we wish to select deservin students who would 0e a0le to succeed at8s. e stron l recommend our honest and eOpect our willin ness to choose the

8olle es accordin to our financial needs. Clease read the conditions of the offers carefull toavoid an confusion.

zin l)u K r7n h s\ c$a 0<n #)Uc nRp # tham ia vào h+ th;n c@c r)*n h iWi _iên ? t.8 Vi+t -am, d'a trên nhu c u tài chLnh c$a 0<n, sS Nu t #4nh #[ c6 0<n tWi c@c tr)*n .

{u@ tr=nh tu n chọn sS d'a trên n n l'c và nhu c u tài chLnh c$a thL sinh. 8@c học 0Xntoàn ph n sS #)Uc trao cho nh!n học sinh th'c s' c n học 0Xn # c" th theo học. 8@c su%thọc 0Xn 0@n ph n và su%t học t' tyc sS #)Uc trao cho c@c học sinh c" ?h n n ?inh t #tran tr i mRt ph n ho c toàn 0R c@c ?ho n chi phL. Vi+c tu n chọn t%t c học 0Xn toànph n, học 0Xn 0@n ph n và su%t học t' tyc sS #)Uc th'c hi+n riên rS.

3;i vWi c 0a lo<i, chyn tTi mon mu;n chọn #)Uc nh!n học sinh O&n #@n và c" th thànhcTn t<i c@c r)*n h iWi _iên ? t. 8hyn tTi #@nh i@ cao s' trun th'c và s|n sàn c$athL sLnh tron vi+c l'a chọn ph hUp vWi ?h n n tài chLnh c$a m=nh. 3[ n h4 c@c thL sinh #ọcr #i[u ?i+n c$a t n lo<i học 0Xn # tr@nh hi u l m.

F 55 ? 8/59 ?8: ? H ; ./@; 8X;

Aach of the followin nited orld 8olle es offers 1 (one full scholarship to Vietnamesestudents. Full scholarships cover tuition, room and 0oard for two ears at the school. nlessotherwise indicated, full scholarships do not include travel, poc?et mone and medicalinsurance. he offer of full scholarship ma 0e need 0ased. E 1}}~ scholarship will onl 0eawarded to a student who reNuires full financial support. his allows the 8 s stem toeOtend our scholarship support to a reater num0er of students. 8 Vietnam and parents onthe chosen students will ne otiate and a ree on the parentsJ contri0ution 0efore nomination ismade to the 8s. Clease list the followin schools in order of preference (1 for mostpreferred and for least preferred .

8@c r)*n h iWi _iên ? t d)Wi #P , m•i tr)*n c%p 1 (mRt học 0Xn toàn ph n cho họcsinh Vi+t -am. Học 0Xn toàn ph n 0ao m chi phL cho học phL, ph`n I và n u;n tronv`n hai n m theo học t<i tr)*n . - u ?hTn hi thêm chi ti t, học 0Xn toàn ph n ?hTn 0ao

m chi phL #i l<i, ti[n tiêu v t và 0 o hi m t . Vi+c cun c%p học 0Xn toàn ph n ph] thuRcvào nhu c u tài chLnh c$a học sinh. Học 0Xn tr4 i@ 1}}~ sS ch5 dành cho nh!n thL sinh?hTn c" ?h n n chi tr 0%t c& ?ho n ?inh phL nào. 3i[u nà cho ph€p h+ th;n 8 c" thmI rRn vi+c h• trU học 0Xn tWi nhi[u học sinh h\n. 8 Vi+t -am và cha mZ nh!n học sinh#)Uc chọn sS thQa thuYn và th;n nh%t m&c #"n "p c$a cha mZ học sinh tr)Wc ?hi 8 Vi+t-am 6i #[ c6 san c@c tr)*n . H #@nh s; c@c tr)*n sau theo th& t' )u tiên (thLch nhi[unh%t: s; 1 thLch Lt nh%t: s; .



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8 ili an 8olle e, Ermeniar)*n h iWi _iên ? t ili an, Ermenia

0eedsEbased of up to FGGH of the cost of the student of about U JKG,GGG fortwo years.TLy thu c nhu c u t$i chMnh, c? thN t:i FGGH chi phM m t h3c sinh t(Ong'(Ong kho)ng KG.GGG ' la PQ cho hai n*m theo h3c.

8 aastricht, he -etherlandsr)*n h iWi _iên ? t aastricth, Hà _an

0eedsEbased of up to FGGH of the cost of the student of about RSG,GGG fortwo years.TLy thu c nhu c u t$i chMnh, c? thN t:i FGGH chi phM m t h3c sinh t(Ong'(Ong kho)ng SG.GGG OEr cho hai n*m theo h3c.

8 Douth Aast Esia, Din aporer)*n h iWi _iên ? t 3Tn -am ‚, zinh9 a9po

or one girl= travel, medial insurance and pocket money included.$nh cho m t n% sinh= c? th<m chi phM 'i lBi, b)o hiNm y t1 v$ ti n ti<u v t.

Cearson 8olle e 8, 8anadar)*n h iWi _iên ? t Cearson, 8anada 0eedsEbased of up to FGGH of the cost of the student of about U JXS,GGG fortwo years.TLy thu c nhu c u t$i chMnh, c? thN t:i FGGH chi phM m t h3c sinh t(Ong'(Ong XS.GGG ' la PQ cho hai n*m theo h3c.

8 o0ert bosch 8olle e, qermanr)*n h iWi _iên ? t o0ert bosch, 3&c

0eedsEbased of up to FGGH of the cost of the student of about RSG,GGG fortwo years.TLy thu c nhu c u t$i chMnh, c? thN t:i FGGH chi phM m t h3c sinh t(Ong'(Ong kho)ng SG.GGG OEr cho hai n*m theo h3c.

P9 .:95 ? 8/59 ?8: H ; ; 8X;

he followin 8s offers partial scholarships to Vietnamese students. Clease chec? ( ƒ the0elow 0oO onl if our famil can afford the mentioned fees. >nce chec?ed, 8 Vietnam willassume that ou are no lon er interested in competin for an of the full scholarshipsmentioned a0ove.8@c tr)*n 8 sau cun c%p học 0Xn 0@n ph n cho học sinh Vi+t -am. 8h5 #@nh d%u (ƒvào c@c T sau n u ia #=nh 0<n c" ?h n n chi tr cho c@c chi phL #)Uc #[ cYp # n. 8 Vi+t-am sS i #4nh là mRt ?hi # #@nh d%u vào T nà , 0<n ?hTn mu;n tham ia thi tu n #nhYn c@c học 0Xn toàn ph n # nêu I trên.

8 ahindra 8olle e, gndia: 2 (two partiall 9funded places

r)*n h iWi _iên ? t ahindra, „n 3R: 2 (hai su%t học 0Xn 0@n ph nThe student pays SGH of the cost of the student, which is e7ual to I0Y Z[S,GGG per year in addition to travel, pocket money and pro\ect weeks.]3c sinh '?ng g?p SGH chi phM h3c t#p, t(Ong '(Ong v:i Z[S.GGG ruEpi m t n*mv$ chi phM 'i lBi, ti<u v t v$ tham gia c"c d/ "n.

8 aterford âmhla0a, Dwakilandr)*n h iWi _iên ? t aterford âmhla0a, Dwakiland

tudent pays XGH of the cost of the student, in addition to travel, pocket moneyand pro\ect weeks. The the cost of the student are ûro FZ,GGG per year. Theselected student will start in _anuary `GFS, 0 T eptember `GF and finish by0ovember `GFK.



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]3c sinh '?ng g?p XGH chi phM h3c t#p v$ chi phM 'i lBi, ti<u v t v$ tham gia c"cd/ "n. Chi phM h3c t#p tBi tr(9ng l$ FZ.GGG OEr m t n*m. ]3c sinh s> b t ' uh3c th"ng FE`GFS, ] 0 ph)i th"ng E`GF , v$ k1t th c v$o th"ng FFE`GFK.

P59 3 ;.? Y:.8/ . Z ;6:; S [. 8 .\ .]

he followin 8 offers 1 (one placement without fundin to Vietnamese students. Cleasechec? ( ƒ on the 0elow 0oO onl if our famil can afford the mentioned fees. >nce chec?ed,8 Vietnam will assume that ou are no lon er interested in competin for an of the full orpartial scholarships mentioned a0ove.

r)*n 8 sau cun c%p 1 (mRt su%t học cho học sinh Vi+t -am mà học sinh ph i thanhto@n toàn 0R chi phL. 8h5 #@nh d%u (ƒ vào c@c T sau n u ia #=nh 0<n c" ?h n n chi tr choc@c chi phL #)Uc #[ cYp # n. 8 Vi+t -am sS i #4nh là mRt ?hi # #@nh d%u vào T nà , 0<n?hTn mu;n tham ia thi tu n # nhYn c@c học 0Xn toàn ph n ho c 0@n ph n # nêu I trên.

SCHOLARSHIPS FOR GLOBAL COMPETITIONH"C B#NG C+NH TRANH TO N C<U

Dince 2}11 8 ed 8ross -ordic, -orwa , has 0een offerin full funded scholarships tostudents who are victims of land mines. his ear 8 ed 8ross -ordic considers wideninthe selection to victims sufferin from other ph sical in uries as a result of war crimes. 8

ed 8ross -ordicJs close co9operation with ed 8ross Hau land eha0ilitation 8entre hasena0led the school to support the students 0e ond their needs for educational support. his

oint pro ect is supported 0 the g8 8 Dpecial Fund for isa0led, the -orwe ian ed 8ross andthe -orwe ian inistr of Forei n Effairs. For start in A ?. 2014 , there are .Y/ Z 557Z ;6 6 ? 8/59 ?8: ? for lo0al competition on offer at 8 ed 8ross -ordic. 8 Vietnamencoura es students who have 0een in ured 0 land mines or are eOperiencin ph sicaldisa0ilit to appl for this pro ram. our application will 0e treated separatel . Clease chec?the a0ove 0oO and eOplain 0elow our in ur and the circumstance that led into it.

^ t n m 2}11, r)*n h iWi _iên ? t 8h! thYp #Q -ordic t<i -a9u , 0Gt # u cun c%p c@csu%t học 0Xn toàn ph n cho c@c học sinh là n<n nhPn c$a 0om m=n. - m na , r)*n -ordicmI rRn di+n tham ia cho học sinh 04 th)\n tLch ?h@c do c@c tRi @c chi n tranh. ;i Nuan h+mYt thi t i!a r)*n -ordic và run tPm ph]c h i ch&c n n c$a HRi 8h! thYp #Q Hau landcho ph€p tr)*n c" th h• trU học sinh n oài nhu c u i@o d]c thTn th)*n . ' @n nà do{u… h• trU n )*i ?hu t tYt c$a HRi 8h! thYp #Q Nu;c t , HRi 8h! thYp #Q -a9u và bR - o<i

iao -a9u tài trU. bGt # u t th@n ^=2014 , tr)*n sS dành 89: ? [. 8 ; ./@; 8X; tron #" † 0an 8 c@c n)Wc c" th c6 &n viên. 8 Vi+t -am ?hu n ?hLch c@c thL sinh?hu t tYt do 0om m=n ho c do c@c lK do ?h@c nRp h s\ vào học 0Xn nà . H s\ c$a 0<n sS#)Uc O6 lK riên rS. H #@nh d%u vào T trên và i i thLch phLa d)Wi t=nh tr<n ?hu t tYt c$a0<n và t=nh hu;n d‡n # n ?hu t tYt #".

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8 Etlantic 8olle e, he nited ^in domr)*n h iWi _iên ? t Etlantic, Enh

tudent pays FGGH of the full fees for two years, e7ual to about S`,GGG, inaddition to travel, pocket money and pro\ect weeks.]3c sinh thanh to"n FGGH t4ng chi phM cho hai n*m h3c, t(Ong '(Ongkho)ng S`.GGG b)ng nh, v$ chi phM 'i lBi, ti<u v t v$ tham gia c"c d/ "n.



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PART 4 = ./ /3 5 . 6 7 .8 9 5: 9;.PH<N 4 = 6/ .8> ?:;8 8/@; .8: ;1. _ist and descri0e our level of interest, participation and achievements in school activities

(school, volunteer roups, atheletics, arts, etc .H li+t ?ê và mT t s' êu thLch, m&c #R tham ia và thành tLch c$a em tron ho<t #Rnc$a tr)*n (học tYp, t=nh n u +n, th thao, n h+ thuYt, v.v.. .

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................................................................................................................................2. _ist and descri0e our level of interest, participation and achievements in activities, roups

and ho00ies not associated with school.

H li+t ?ê và mT t s' êu thLch và m&c #R tham ia c$a em vào ho<t #Rn , nh"m, sIthLch n oài tr)*n học.................................................................................................................................................................................................................................................................

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B. Clease ela0orate more on one activit that demonstrates at least one of the followin : ourleadership s?ills our willin ness to help others our creativit or our 0i est stren th (ifdifferent from the a0ove .H n"i r h\n v[ mRt ho<t #Rn em tham ia # th hi+n #)Uc Lt nh%t mRt tron nh!nphxm ch%t sau c$a em: ?h n n l nh #<o s' s|n sàn iyp #‰ n )*i ?h@c ?h n n s@nt<o ho c phxm ch%t nXi 0Yt nh%t c$a em (n u ?h@c tron nh!n #i m trên .................................................................................................................................

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................................................................................................................................B. hat academic achievement are ou most proud of h

Am t' hào nh%t v[ (nh!n thành tLch học tYp nào c$a m=nh <i sao

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Š / 1M

M. gn addition to Vietnamese, what other lan ua e(s do ou understand Clease indicate 0tic?in the appropriate sNuare: : eOcellent, }: not at all.- oài ti n Vi+t, em 0i t nh!n n Tn n ! nào n!a H #@nh d%u m&c #R thành th<o vàoc@c T sau: : r%t thành th<o, }: ?hTn 0i t =

E; 5:?8T:_; A;8

M B 2 1 } M B 2 1 } M B 2 1 }

Dpea?/-"i Dpea?/-"i Dpea?/-"iead/3ọc ead/3ọc ead/3ọcrite/Vi t rite/Vi t rite/Vi t

gs this lan ua e a su0 ect tau ht at our school- o<i n ! nà c" ph i là mRt mTn học #)Uc d< t<i tr)*n c$a em ?hTn

es / 8" -o / ^hTn

. o ou en o ph sical activities or sports o ou have a stron musical, carft or artisticinterest _ist up to areas of interest indicate level and time of involvement.Am c" thLch tham ia ho<t #Rn th ch%t/th thao ?hTn Am c" êu thLch Pm nh<c, hRiho< ha c@c ho<t #Rn s@n t<o ?hTn H li+t ?ê t;i #a l‹nh v'c mà em êu thLch, nêu

r m&c #R và th*i ian mà em tham ia vào c@c ho<t #Rn nà .................................................................................................................................

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j. gs there an other thin ou want 8 Vietnam to ?now more a0out ouAm c" #i[u = mu;n tr=nh 0à thêm vWi 8 Vi+t -am ?hTn

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.................................................................................................................................. How did ou first hear a0out nited orld 8olle es

_ n # u tiên em 0i t v[ c@c r)*n h iWi _iên ? t nh) th nàognternet. hich site(s / ran nào ..........................................................................

-ewspaper/b@o chL. hich one(s /b@o nào .............................................................

8 Dcholar(s /Học sinh 8. hich scholar /Học sinh nào ....................................Famil /qia #=nh

Friends/b<n 0Œeachers school staff/ h cT i@o, nhPn viên tron tr)*n em #an theo học.

>thers/- u n tin ?h@c: .........................................................................................



1} / 1M

PART ` = ./ /3 5 . 6 7 .8 9 5: 9;.PH<N ` = 6/ .8> ?:;8 8/@; .8: ;

Clease write a statement of not more than B}} words eOplainin wh ou deserve to stud atnited orld 8olle e, descri0in 0oth what ou mi ht contri0ute to the 8olle e and what ou

would hope to ain from our eOperience there.H vi t mRt #o<n v n ?hTn dài Nu@ B}} t i i thLch t<i sao em O&n #@n #)Uc theo học t<imRt r)*n h iWi _iên ? t, mT t c nh!n = em c" th #"n "p và nh!n = em monmu;n thu nhYn #)Uc t r)*n nà .

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otal/ Xn cRn : ..................... words/t



11 / 1M

PART a = ./ /3 5 . 6 7 .8 9 5: 9;.PH<N a = 6/ .8> ?:;8 8/@; .8: ;

Clease write in an essa of less than B}} words a letter to ourself after 2} ears.H vi t mRt 0ài luYn ?hTn Nu@ B}} t d)Wi d<n mRt 0&c th) 6i tWi em tron 2} n m n!a.

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otal/ Xn cRn : ..................... words/t



12 / 1M

PART b - L:?. /Z R Z ; ? 9 ./ /3 5 . 6 7 .8 9 5: 9;.PH<N b = T8c :d: .8: = 6/ .8> ?:;8 8/@; .8: ;

ou are reNuested to as? two referees who ?now ou ver well to write a letter ofrecommendation and return them in sealed envelopes to 8 Vietnam 0efore the deadline.>ne of the referees must 0e a teacher who has tau ht or is teachin ou (other than the

Crincipal or the schoolJs epresentative mentioned in part 1} . he other needs to 0e a personin char e of the or anikation or the communit event that ou were or is a part of. _etters ofrecommendation from friends, famil friends or famil mem0ers are not accepted.

hL sinh h #[ n h4 hai n )*i 0i t r v[ m=nh vi t th) iWi thi+u và 6i th) iWi thi+u tronphon 0= d@n ?Ln # n 8 Vi+t -am tr)Wc n à h t h<n nRp h s\. Rt tron hai n )*i iWithi+u ph i là i@o viên # ho c #an d< em (?hTn ph i Hi+u tr)In ho c - )*i #<i di+n c$atr)*n #[ cYp # n tron ph n 1} . - )*i th& hai là n )*i c" tr@ch nhi+m t<i tX ch&c ho c s'?i+n mà em tham ia tron c@c ho<t #Rn ph]c v] cRn # n . h) iWi thi+u t 0<n 0Œ, 0<nc$a ia #=nh và n )*i tron ia #=nh ?hTn #)Uc ch%p nhYn.

jlease provide names of the referees ] y liDt k< t<n c-a nh%ng ng(9i gi:i thiDu

-ame/ ên elephone/3i+n tho<i Amail

1st reference( eacher- )*i iWi thi+u th&nh%t (qi@o viên

2nd reference- )*i iWi thi+u th&hai

PART ^= ./ /3 5 . 6 7 .8 R Z ?PH<N ^ = 6/ ; ce: :d: .8: 8/@; .8: ;

To the refereesou are invited to write a letter of recommendation on this applicant, either in An lish or

Vietnamese. 8 Vietnam would li?e to ?now our relationship with the applicant, how lonou have ?nown her/him and our assessment of her/his characteristics includin the a0ilit to

wor? with others, adapta0ilit , communication a0ilities, concern for others, creativit , ener ,initiative, maturit and 0alance, motivation, openness of personalit , self9confidence and self9discipline.gn addition to this, ou are ?indl as?ed to have our letter enclosed in this application in asealed envelop. ou ma 0e contacted 0 the 8 Vietnam durin the selection process.

i nh%ng ng(9i gi:i thiDu

8hyn tTi ?Lnh m*i NuK v4 vi t mRt l@ th) iWi thi+u v[ thL sinh nà , 07n ti n Vi+t ho c ti nEnh. 8 Vi+t -am mu;n 0i t v[ m;i Nuan h+ c$a NuK v4 vWi thL sinh, ?ho n th*i ian Nuen0i t và s' #@nh i@ c$a NuK v4 v[ c@c # c #i m c$a thL sinh, 0ao m ?h n n làm vi+c vWith cT và c@c 0<n, ?h n n thLch &n , ?h n n iao ti p, s' Nuan tPm # n n )*i ?h@c, ?hn n s@n t<o, n n #Rn , s@n ?i n, tr)In thành và ?h n n i! cPn 07n , #Rn l'c (tronhọc tYp ho c ho<t #Rn , s' cIi mI, t' tin và tLnh ?Ž luYt t' [email protected]ên c<nh #i[n vào 0 n trên, Oin NuK v4 # th) iWi thi+u c$a m=nh tron mRt phon 0= d@n ?Lnvà 6i cho thL sinh # thL sinh 6i ?Œm theo 0 n # n ?K nà . ron Nu@ tr=nh tu n chọn,

8 Vi+t -am c" th liên h+ vWi NuK v4 # 0i t thêm thTn tin.



1B / 1M

PART f = ./ /3 5 . 6 7 .8 P :; : 95 / 9 ? 8//5 ? R ? ;.9.:gPH<N f = 6/ H: . ch; 8/i 3j. Đk: 6: ; 9 . ce; 8/@; .8: ;

his form should 0e ta?en to our Crincipal or a schoolJs epresentative for her/his attention.hL sinh h man b n # n ?K nà # n cho Hi+u tr)In ho c mRt - )*i #<i di+n c$a tr)*n .

To the applicant s jrincipal or school s Yepresentativehe 8 Vietnam would reatl appreciate our comments on this applicant. our fran?assessment on the applicantJs contri0ution to the school and his/her standin amon otherstudents would 0e invalua0le information for us in ma?in our decision in rantin scholarshipsand placements. Clease provide us with her/his school records and our remar?s in the form0elow. gf ou would prefer to enclose a letter on a separate sheet, please do so.

Mnh g i ]iDu tr(qng ho c 0g(9i 'Bi diDn c-a tr(9ng thM sinh 'ang theo h3c8 Vi+t -am #@nh i@ r%t cao nhYn O€t c$a Tn /0à v[ thL sinh nà . -h!n nhYn O€t th n

thGn c$a Tn /0à v[ s' #"n "p c$a thL sinh t<i tr)*n #an theo học và s' nXi 0Yt c$a thLsinh t<i tr)*n là vT c n NuK i@ iyp chyn tTi #)a ra c@c Nu t #4nh v[ học 0Xn . rên 0 nd)Wi #P , #[ n h4 Tn /0à cun c%p cho chyn tTi ? t Nu học tYp c$a thL sinh t<i tr)*n vànhYn O€t c$a Tn /0à v[ thL sinh. n /bà c‘n c" th 6i mRt th) riên cho chyn tTi.

A 96 3: / 6? K_. l m 8 .

-ame of Dtudent/ ên học sinh: .................................. 8urrent class/_Wp #an theo học: .....

S n .? Mo; 8 G 96 Ld f G 96 Ld 10 G 96 Ld 11 R 39 p? G8: 8]1st term

H^ g2nd term

H^ ggFull ear8 n m

1st termH^ g

2nd termH^ gg

Full ear8-

1st termH^ g

athematics/ o@n học

Ch sics/VYt lK

8hemistr /H"a học

biolo /Dinh họcechnolo /^… thuYt

gnformatics/ in học

Ch sical education/ h d]c

_iterature/V n học

Histor /_4ch s6

qeo raph /34a lK

8ivic Aducation/q 8

An lish/ i n Enh

Evera e/ run 0=nh

)/ 39 p? N8 ; qr. 9 H: . ch; 8/i N ce: Đk: 6: ; 9 . ce; .8> ?:;8

Clease place chec? mar?s at the points that represent our evaluation of the student incomparision to other students in his or her a e roup. gf ou have no fair 0asis for ud ment,do not hesitate to sa so.zin h tLch vào nh!n T ph hUp # th hi+n #@nh i@ c$a Tn /0à v[ học sinh so vWi c@c họcsinh ?h@c c n l&a. - u Tn 0à ?hTn c" c\ sI # #@nh i@, Oin c‘n vui l`n #@nh d%u.



N/. ? G8: 8]E: op 1}~ of students g have ?nown. / Rt tron 1}~ học sinh Ou%t sGc nh%t tTi t n 0i t.b: AOcellent: op 1}~ this ear. / zu%t sGc: Rt tron 1}~ học sinh Ou%t sGc nh%t n m na .8: qood: E0ove avera e. / ;t: rên trun 0=nh.

: -o 0asis for ud ment. / ^hTn c" c\ sI #@nh i@.

A B C DEcademic potential^h n n học tYpEcademic achievement

hành tLch học tYpgntellectual 8uriositD' ham học hQiAffort/ eterminationD' c; GnE0ilit to wor? independentl^h n n làm vi+c #Rc lYp>r anikation

Lnh tX ch&c8reativitD&c s@n t<oillin ness to ta?e intellectual ris?sD|n sàn m<o hi m8oncern for othersD' Nuan tPm # n n )*i ?h@cHonest /gnte rit

Lnh trun th'cDelf9esteem_`n t' trọn

aturit (relative to a eD' tr)In thành

esponsi0ilitinh th n tr@ch nhi+m

espect accorded 0 facult3@nh i@ c$a th cTespect accorded 0 peers

3@nh i@ c$a 0<n 0ŒAmotional sta0ilitD' cPn 07n v[ tPm lK>verall evaluation as a student3@nh i@ tXn Nuan v[ học sinh>verall evaluation as a person3@nh i@ tXn Nuan v[ con n )*iO.8 39 p? N8 ; qr. p8 ..........................................................................................................................................................................................................................

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.....................................................................................................................................Di nature/8h! ?K: . ate/- à : .........................................................-ame/ ên: ..Cosition/8h&c v]: ................................................

2014 uwc vietnam appli form

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