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Residents details

Country of Permanent Residence: *

Country of Birth: *

 
 

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Employment Information

 

Current Employer: *

Job Title: *

Gross Monthly Income: Please provide a copy of last three pay slips or HR Letter:

 
 

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How would you finance the non-scholarship element of your program fees? *

SelfFamilyOther

Please detail below how you intend to fund the balance of the program fees *

 
 

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Do you have children/adults who rely on your income for support? *

Please list full details below.

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Reference

Please provide reference as to character, conduct and eligibility for this scholarship. Cannot be a family member. Please attach letter to this application.

Referee’s Name: *	Referee’s Occupation: *
Referee’s Phone Number: *	Referee’s Email Address: *

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Scholarship Application History

Have you ever been admitted at Agora University before? * YesNo

If yes, please provide program name, year, and reason for not joining the program

 
 

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Have you ever applied for a scholarship with Agora University before? * YesNo

If yes, which scholarship, year it was offered, and if you completed the program.

 
 
 
 

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Declaration

I hereby declare that the information contained in this form of application are correct and I confirm that i will notify Agora School of Business of any changes.

I also understand that the scholarship award decision is at the sole discretion of Agora School of Business and that there is no right of appeal.

I confirm that I would be happy to be contacted by Agora School of Business for an interview if required.

By signing your name electronically on this form, You are agreeing that your electronic signature is the legal equivalent of your
manual signature on this form. *

Signature: *

Date: