MINISTRY OF EDUCATION

Website: http://www.uni-sofia.bg/

Sophia University http://www.4icu.org/bg/

E-mail: bulgariajames@yahoo.com

_________________________________________________________________________

APPLICATION FORM

BULGARIAN GOVERNMENT SCHOLARSHIP PROGRAMS

INSTRUCTIONS

Please answer each questions clearly and completely. Type or print in ink.

affix photo here

4 × 6 cm

A. PERSONAL DETAILS

1. a. Family name : ___________________________________

b. First name : ______________________________________

2. Date of birth : ______________________________________

3. Place of birth : _____________________________________

4. Male/Female : ______________________________________

5. Nationality : ________________________________________

6. Passport Number : ___________________   Valid Until : _____________________

7. a. Marital status : □ Single           □ Married

b. Do you have a husband/wife or any dependants?

(Please give details of name, relationship and date of birth)

NO	NAME	RELATIONSHIP	AGE

8. Permanent address in home country :

__________________________________________________________________________

__________________________________________________________________________

9. a. Employment (present) :

__________________________________________________________________________

b. Name and address of organization :

__________________________________________________________________________

__________________________________________________________________________

B. EDUCATION

Name and Location of Institution	Subject of Study	Dates	Qualifications Obtained

C. LANGUAGE: State proficiency Good-Fair-Elementary

SKILLS	Bulgarian	English	Others
Speaking
Understanding
Writing

D. PROPOSED FIELD OF STUDY

1. Subject : _________________________________________________________________

_________________________________________________________________

2. Outline your proposed field of study and indicate the practical use to be made     of this study.

_____________________________________________________________________________

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E. EMPLOYMENT DETAILS

Years	Descriptions of Occupation	Employer

F. OTHER

Experience abroad

No	Country	Purpose	Year

G. DECLARATION

If accepted for the scholarship, I agree ;

1. to abide by the rules of the university or college

2. not changing either subject of place study prior or upon arrival in Bulgaria

3. to refrain myself from political activities or any form of employment for          profit or gain

4. not involve in any misconduct and any form harassment

5. to refrain from being pregnant and being involved in drug traffic and abuses

6. to be sent back to home country if I violate the stay permit in Bulgaria

and the said regulations above.

I certify that the statement I have made in response to the foregoing questions are true, completed and corrected to the best of my knowledge.

Date                                Signature

______________________                 _______________________