In partnership with

COMMONWEALTH SCHOLARSHIP APPLICATION FORM

(SIXTH-FORM PROGRAMME)

All information stated in this document is correct at the time of published and subject to change without notice. 2

ELIGIBILITY

In order to apply for this scholarship, please ensure that you:

are a citizen of an eligible Commonwealth country (please refer to page 7)

will be below 17 years of age when starting at King Henry VIII College

meet our academic entry criteria (minimum of 5 A* - C in IGCSE or equivalent qualification)

are able to commence school at King Henry VIII College, Malaysia for the 2-year Sixth FormProgramme, for the September 2020 Term

have provided all required supporting documents along with this application

and your parents will abide by the ‘Terms and Conditions’ stipulated on page 8

SUPPORTING DOCUMENTS REQUIRED ALONG WITH THIS APPLICATION

Please confirm (tick √) all the documents are attached with this application:

your passport and birth certificate

your certified academic credentials (high school academic reports for the last 2 (two) years,

and any high school external examination certificates) with English translations

your parents’ certified bank statements and pay slips for the last 3 (three) months

your current Head Teacher’s Testimonial

If you have any question providing the above documents, please contact us at scholarships@kinghenryviii.edu.my

IMPORTANT NOTES & DATES

Closing date for application: 30th April 2020, 1600 hrs (GMT)

Shortlisted candidates Skype interviews: 4th to 15th May 2020

Final selection of recipients: 16th to 31st May 2020

Announcement of successful recipients: 1st June 2020

Please return this completed form either electronically to the Scholarship Committee at scholarships@kinghenryviii.edu.my or by courier to:

The Head’s Office Commonwealth Scholarship Committee King Henry VIII College, Persiaran Bestari, Cyber 11, 63000 Cyberjaya, Selangor, Malaysia Tel: +60-3-8800 9888

All information stated in this document is correct at the time of published and subject to change without notice. 3

STUDENT’S NAME AS PER PASSPORT

NAME: _____________________________________________ PREFERRED NAME: __________________________ Please underline family name

DATE OF BIRTH: ______ / ______ / _______ GENDER: ⬜ Male ⬜ Female

day month year

PASSPORT NO: _______________________________ RELIGION: __________________________________

MAIN SCHOOL LANGUAGE(S): __________________________ YEARS TAUGHT IN ENGLISH: ___________________

HOME LANGUAGE(S): MAIN: __________________________, OTHERS: ___________________________________

PARENTS’ DETAILS

MOTHER’S FULL NAME: ___________________________________________________________________________ as per passport

Home Address: ___________________________________________________________________________

Postcode: ___________________________ E-mail: _____________________________

Tel. No.: ___________________________ Mobile No.: _____________________________

Occupation: ___________________________ Annual Income: _____________________________

FATHER’S FULL NAME: ___________________________________________________________________________ As per passport

Home Address: ___________________________________________________________________________

Postcode: ___________________________ Email: _____________________________

Tel. No.: ___________________________ Mobile No.: _____________________________

Occupation: ___________________________ Annual Income: _____________________________

All information stated in this document is correct at the time of published and subject to change without notice. 4

STUDENT’S LATEST EDUCATIONAL HISTORY & ACADEMIC INFORMATION

Name of School: ___________________________________________________________________________

Main School Language: ___________________________________________________________________________

Name of Head Teacher: ___________________________________________________________________________

School Tel. No.: ___________________________________________________________________________

School e-mail address: ___________________________________________________________________________

Please list externally sat examinations (with grades) already completed and/or currently working towards and predicted grades on completion:

______________________________________________________________________________________________

______________________________________________________________________________________________

______________________________________________________________________________________________

Scholarship applying for: _____ Academic _____ Art & Design (Please tick those that apply)

_____ Performing Arts (Music/Drama) _____ Sports

Where do you hope to pursue your higher education? Include country, course, and field of employment.

______________________________________________________________________________________________

______________________________________________________________________________________________

______________________________________________________________________________________________

Which A-Level subjects do you wish to study? (note in order of preference)

1. _______________________________________ 3. ________________________________________

2. _______________________________________ 4. ________________________________________

What additional interests or hobbies do you have? (e.g participation in Model United Nations, sports teams, etc.)

_______________________________________________________________________________________________

_______________________________________________________________________________________________

Please give examples of leadership positions you have held (e.g supporting younger students, positions of responsibility in and out of school, etc.)

_______________________________________________________________________________________________

_______________________________________________________________________________________________

All information stated in this document is correct at the time of published and subject to change without notice. 5

Personal Statement (can be either handwritten or typed but MUST be completed only by applicant)

Please, in your own words, tell us why you believe you are deserving of the scholarship you have applied for. What

qualities could you bring to the School? Please include in your statement any relevant experiences and achievements

that will support your scholarship application. Before we award any scholarships, we may ask to see corroborating

evidence to support what you may write. As a guide, this personal statement should be no longer than 350 words.

___________________________________________________________________________

All information stated in this document is correct at the time of published and subject to change without notice. 6

DECLARATION OF PARENTS

I confirm that the enclosed information and statements are true and correct. I understand that any false or misleading information, or the withholding of relevant information relating to this application, might invalidate my child’s application.

In applying for the Scholarship, I also hereby acknowledge that my child’s attached personal statement is his/her own work.

1st Signatory : 2nd Signatory :

Name : Name :

Relationship to child : Relationship to child :

Date : Date :

DATA PROTECTION

1. The personal data I/we have provided in this form will be used by or on behalf of King Henry VIII College to

send me further details, including its events, academic programmes and marketing promotion. By checking

the box below, I/we wish that I/we could be excluded from the communications.

Please exclude me/us from the above communications.

2. My/Our personal data may be additionally shared from time to time with King Henry VIII College’s appointed

agents who are working within the school. By checking the box below, I/we wish that my/our information

not to be disclosed.

Please do not disclose my/our information.

3. I/We will contact King Henry VIII College for access into my/our personal data or will notify the School of any

changes in information I/we have provided.

4. By signing this form, I/we confirmed that I/we have:

i. read, understood the contents and voluntarily completed this form

ii. consent from my parents/guardian in providing information in this form, if I am below 18 years of age

Signatory Name Date

All information stated in this document is correct at the time of published and subject to change without notice. 7

LISTS OF ELIGIBLE COMMONWEALTH COUNTRIES

Africa

Botswana

Cameroon

Gambia, The

Ghana

Kenya

Kingdom of eSwatini

Lesotho

Malawi

Mauritius

Mozambique

Namibia

Nigeria

Rwanda

Seychelles

Sierra Leone

South Africa

Uganda

United Republic of Tanzania

Zambia

Pacific

Australia

Fiji

Kiribati

Nauru

New Zealand

Papua New Guinea

Samoa

Solomon Islands

Tonga

Tuvalu

Vanuatu

Asia

Bangladesh

Brunei Darussalam

India

Malaysia

Maldives

Pakistan

Singapore

Sri Lanka

Caribbean and Americas

Antigua and Barbuda

Bahamas, The

Barbados

Belize

Canada

Dominica

Grenada

Guyana

Jamaica

Saint Lucia

St Kitts and Nevis

St Vincent and The Grenadines

Trinidad and Tobago

Europe

Cyprus

Malta

United Kingdom

All information stated in this document is correct at the time of published and subject to change without notice. 8

TERMS & CONDITIONS

A. Applicants must be a citizen on the list of Commonwealth Countries.

B. Applicants must meet the criteria and requirements as indicated in the COMMONWEALTH SCHOLARSHIPS AWARDSBROCHURE before an offer of award can be made. Applicants who do not meet the criteria and requirements will bedisqualified without notice.

C. Applicants must be of the appropriate age to begin a Sixth Form study programme. Successful applicants must be underthe age of 17 when starting at the school.

D. Applicants must have a guardian (either self- or school-appointed) who can take care of them when they are schoolingat King Henry VIII College.

E. Applicants must not have the means to fund the tuition and boarding without the assistance this scholarship provides.

F. Relevant forecast results will be taken into account if official results have not been released at the point of application.However, the scholarship will be awarded only when actual results are provided. The actual results must meet theeligibility requirements.

G. The scholarship is neither transferable nor exchangeable for cash or other alternatives.

H. To maintain the scholarship award, students must perform at a level that satisfies the scholarship criteria - this will beunder constant review.

I. The School may terminate the scholarship if an award holder:

1. fails to meet the scholarships terms and conditions2. fails to maintain satisfactory academic progress3. fails to maintain an appropriate standard in the area of scholarship4. is excluded from the school5. has provided incorrect, false or misleading information or withheld relevant information on the scholarship

application - or after receiving a scholarship offer

J. It is compulsory for scholarship recipients to represent King Henry VIII College in relevant events as and when required.

K. Recipients who are unable to participate in such events are required to submit a written explanation and supportingdocuments to the Head of the school stating the reason.

L. The recipient may also be requested to assist in King Henry VIII College’s promotional activities as and when required bythe Head and relevant staff.

M. King Henry VIII College reserves the right to involve Commonwealth Scholars in interviews, advertisement, and mediaactivities for the purpose of promoting the School. All products of these activities are the copyright of the school and canbe used without prior written or verbal permission.

N. Should the recipient be in acceptance of any other scholarship of any amount whatsoever, the School must be notified.

O. All Scholars at King Henry VIII College are required to comply with all School rules & regulations at all times.

P. The scholarship will cease upon completion of the final period of study.

Q. King Henry VIII College reserves the right to alter any of the terms and conditions of the Commonwealth ScholarshipsAward scheme at any time. Award holders and parents/relevant parties will be notified of any such changes.

R. Failure to comply with any of the terms and conditions related to this scholarship would amount to a breach of contractand King Henry VIII College reserves the right to terminate the scholarship if the student does not abide by the terms andconditions stated.

S. In the event of any dispute about a student’s eligibility for the scholarship, the decision made by the King Henry VIIICollege Commonwealth Scholarship Awards Committee is final.

Published date:: 26th February 2020