STUDENT SPONSORSHIP / BURSARY APPLICATION FORM STUDENT SPONSORSHIP / BURSARY APPLICATION FORMΔSECTION 1: APPLICANT IDENTIFICATIONFirst NameLast NameDate of BirthGender- Select -MaleFemaleNationalitySelect CountryAfghanistanAland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Saint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBritish Virgin IslandsBruneiBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicDemocratic Republic of the Congo (Kinshasa)DenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyIvory CoastJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacao S.A.R., ChinaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestinian TerritoryPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRepublic of the Congo (Brazzaville)RomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint Martin (Dutch part)Saint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia/Sandwich IslandsSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUgandaUkraineUnited Arab EmiratesUnited Kingdom (UK)United States (US)United States (US) Minor Outlying IslandsUnited States (US) Virgin IslandsUruguayUzbekistanVanuatuVaticanVenezuelaVietnamWallis and FutunaWestern SaharaYemenZambiaZimbabweCountry of ResidenceSelect CountryAfghanistanAland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Saint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBritish Virgin IslandsBruneiBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicDemocratic Republic of the Congo (Kinshasa)DenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyIvory CoastJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacao S.A.R., ChinaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestinian TerritoryPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRepublic of the Congo (Brazzaville)RomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint Martin (Dutch part)Saint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia/Sandwich IslandsSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUgandaUkraineUnited Arab EmiratesUnited Kingdom (UK)United States (US)United States (US) Minor Outlying IslandsUnited States (US) Virgin IslandsUruguayUzbekistanVanuatuVaticanVenezuelaVietnamWallis and FutunaWestern SaharaYemenZambiaZimbabweState / Region of ResidencePhone NumberEmail AddressNational ID / Passport NumberFirst-generation university student? Yes NoDisability or Special Learning Needs None Physical Visual Hearing Learning-related Prefer not to saySECTION 2: EDUCATIONAL PROFILECurrent Level of Education- Select -Secondary SchoolUndergraduatePostgraduateVocational / TechnicalName of InstitutionInstitution Location – CityInstitution Location – CountryCourse of Study / ProgrammeYear of StudyExpected Graduation DateCurrent Academic PerformanceUpload most recent transcript or result slipChoose File Upload Admission LetterChoose File Upload Student ID CardChoose File Have you ever deferred, repeated, or withdrawn from a programme? Yes NoState the program and reasons for defering, repeat or withdrawalSECTION 3: FUNDING REQUESTType of Support Requested Tuition fees Examination fees Learning materials (books, laptop, data) Accommodation OtherOtherTotal Amount RequestedDuration of Support Requested One-off 6 months 12 monthsHas this cost already been partially funded? No YesSource and AmountTuition AmountDo you have evidence of your tuition amount? Yes NoUpload Tuition EvidenceChoose File Accomodation AmountDo you have evidence of your accomodation amount? Yes NoUpload Accomodation EvidenceChoose File Books/Laptop/Data AmountDo you have evidence of your Books/Laptop/Data amount? Yes NoUpload Accomodation EvidenceChoose File OthersUpload EvidenceChoose File Do you have evidence of your other amount? Yes NoUpload fee invoice, school bill, or official cost documentChoose File Has delayed payment previously affected your studies? Yes NoGive more detailsSECTION 4: FINANCIAL NEED ASSESSMENTPrimary Financial Sponsor Parent(s) Guardian Self OtherEstimated Monthly Household Income- Select -Below ₦50,000₦50,000 – ₦100,000₦100,001 – ₦250,000₦250,001 – ₦500,000Above ₦500,000Number of Dependents Supported by This IncomePrimary Sponsor’s Employment Status- Select -Employed (formal)Employed (informal)Self-employedUnemployedRetiredDeceasedAny other scholarships or bursaries currently held? Yes NoMore detailsAny major financial shock in the last 12 months? Medical Loss of job Death of sponsor Natural disaster NoneBrief explanation of financial circumstancesSECTION 5: MERIT, MOTIVATION & ALIGNMENTWhy did you choose this course of study?What career do you intend to pursue after graduation?How will this education positively impact your community or society?Alignment with MILUA Education Foundation’s mission of access, equity, and community developmentSECTION 6: CHARACTER & RESPONSIBILITYLeadership, volunteering, or community service experienceWhat would you do if this bursary were not awarded?Have you ever been disciplined, suspended, or sanctioned by an institution? Yes NoGive more detailsWillingness to participate in mentoring, volunteering, or impact reporting if awarded? Yes NoSECTION 7: REFEREESName of Academic / Institutional RefereePosition of Academic / Institutional RefereeInstitution of Academic / Institutional RefereeInstitution of Academic / Institutional RefereeEmail of Academic / Institutional RefereePhone/Mobile of Academic / Institutional RefereeName of Community / Religious / Employer RefereePosition of Community / Religious / Employer RefereeOrganizationEmailPhone/MobileUpload reference letter(s)Choose File Permission to contact refereesSECTION 8: DECLARATIONS & CONSENT Declaration of accuracy Consent for data use Consent for academic monitoring and progress updates Media & impact communication consent Acknowledgement of verification and anti-fraud checksSignatureSubmit Form
