Student Candidate Application Form
Introduction:
This application form is to be filled out by a student wishing to have his or her college fees paid for by a Sponsor. There are two sections to this form:
• Section 1 is to be filled out by the student.
• Section 2 is to be filled out by the college.
Section 1 (Student: Please answer all questions)
First Name:__________________________ Last Name:_____________________
Date of Birth: _________ Month ___________ Date _______ Year
Home Address: ______________________________________________________
City: _________________Postal Code: ________________ Country: _______________
Email: _______________
How often can you access your email? ____________________________________
Please notify Kapadia Education Foundation immediately of any change in email address.
I have completed my high school education,
or will complete it by (month, date, year): _________________________________
On a separate piece of paper, please describe how you will pay for all costs not covered by sponsorship, what you will do after you graduate, and how your college education will help you and your community.
Section 2 (To be filled out by the responsible College or University Administrator)
____________________________________ (student) was accepted on (month, date, year) ________________________________ to this college or university (name) ____________________________________ for admission in the following program: ____________________________________ (describe program); and upon successful completion of his/her studies, will graduate by the following date (month, date, year) ____________________ with a degree in _________________________.
The annual cost of tuition, room (lodging) and board (food) is approximately __________________ (in local currency). The annual limit is US$500/year for tuition, room and board, and applications for more than $500 per year will be denied.
This College agrees to provide transcripts of the student’s progress (grades, rank, and whether promoted each year) to Kapadia Education Foundation with the understanding that Kapadia Education Foundation will only use this information for purposes of funding the student for each subsequent year.
Signed: ____________________________ Name: _________________________
Date:______________________________
Student Pledge
• I have been accepted to the _________________________ college (college or university name), located in ________________ (city) for studies starting in ________________ (month and year).
• My family cannot afford to pay for my college costs. Without financial assistance, I would not be able to attend this college.
If accepted for financial assistance by the Kapadia Education Foundation, I pledge the following:
1) That any financial assistance by Kapadia Education Foundation’s sponsors will be used only for tuition, room (lodging), board (food), and communication costs (postage or email) and nothing else; all other expenses, including clothing, travel and pocket money will be paid for by other sources. I will not ask my sponsor for any additional funds except for those used for my college costs.
2) That in order to continue to receive financial assistance, I will have to remain a student in good standing at the college, and as a minimum have passing grades each year; and that I will be responsible for sending the official college grades to the Foundation at the end of each study term.
3) That I will send monthly progress reports in the form of letters or emails to my sponsor; and that I will ask my sponsor for any non-financial help such as advice or opinions related to my college studies that may help me succeed in college.
4) That upon graduating from college, I will help find another potential student who needs financial assistance and refer him or her to the Kapadia Education Foundation.
5) That upon being established in a paying job or business, I will provide financial support of at least 25% of the cost of a college education for another student from my home country in the Kapadia Education Foundation program; and
6) That at no time will I make money in the form of commissions or fees from potential Student Candidates or from the Foundation.
I have read the Student Pledge. By signing below, I agree to follow the terms and conditions upon which financial assistance will be given to me. I agree that if I do not follow these terms and conditions, I will no longer be eligible for financial assistance.
_______________________________________________________________
Signature Today’s Date