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Application Form

Supportive Scholarships under the

Design, Business and Technology Management Program

Academic Year 2020

The applicant’s general information

- Name (Mr. / Mrs. / Ms.)...................................Middle name................................Family name............................................

- National ID Number/ Passport Number.......................................Birthplace.............................Religion.............................

- Address: House number:.......................................Village number:..............Road:..............................................................

Street:..............................................Sub-district:..............................................District:...............................................................

Province:.................................. Country………………………Postal code:.................. Home phone number:........................

Mobile phone number:.....................................................................................

- Current address: House number:...............................Village number:..............Road:......................................................

Street:..............................................Sub-district:..............................................District:...............................................................

Province:...............................................Postal code:.......................................Phone number:...............................................

- In case that the applicant is staying in a dormitory: Dormitory name:....................................................................... ....

Phone number.............................................................................................................................. ....................................................

The applicant’s educational background

Middle school School:...............................................................Province:................................................................

GPAX:............................................

High school School:............................................................... Province:...............................................................

GPAX:..........................................

Higher education School:............................................................... Province:...............................................................

GPAX:..........................................

The applicant’s family information

- Farther name..............................................................................Age.....................

Deceased Cohabiting Separated Divorced

- Occupation:............................................Job description:..........................................................................................................

Position / Rank ...............................................................................Monthly income.......................................................THB

Workplace...............................................................................Province.............................................................. .........................

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Phone number:........................................................Mobile phone number:..........................................................................

- Mother name..............................................................................Age.....................

Deceased Cohabiting Separated Divorced

- Occupation:............................................Job description:...................................................... ...................................................

Position / Rank ...............................................................................Monthly income.......................................................THB

Workplace...............................................................................Province............................. ..........................................................

Phone number:........................................................Mobile phone number:.................................... ......................................

Applicant’s parents’s living condition

Parents own a land Parents reside other persons

Parents are renting a house for ............................................ THB per month

Parents are renting a land for ............................................ THB per month

The applicant has .................... relatives (quantity, including the applicant).

The applicant is the ……………………. child (order).

- The applicant’s Parents, or guardians have approximately.......................................THB debt per year.

The applicant’s financial sponsor

- The applicant is financially sponsored by:

Father and mother Either father or mother No one financially sponsor the applicant

Other person (Name):.......................................................Relation toward the applicant: ......................................

House number:...............................Village number:..............Road:............................................... .......

Street:..............................................Sub-district:..............................................District:............................................................. ..

Province:...............................................Postal code:.......................................Phone number:...............................................

- The sponsor’s occupation.......................................Position / job description....................................................................

Workplace................................................................... Phone number:........................................................

Mobile phone number:................................................................

- Monthly income......................................THB. The sponsor approximately has...............................................THB debt.

The applicant’s livelihood

Living with father and mother Living with father Living with mother

Living with sponsor

Living in a dormitory, and pay …………………………………. THB rental fee per month

Living with friends or other persons

In other cases, please identify............................................................................

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Educational backgrounds of the applicant and relatives

No. Gender Workplace / School Education level Average monthly

income

(Only working persons)

The applicant’s incomes / expenses

- The applicant has daily weekly monthly income which is ………………………….………………. THB per day

- Travelling costs ............................................................THB/day

- Educational costs ........................................................THB/month

- Other expenses ...........................................................THB/month

- The applicant is earning extra incomes by (Please identify the job description).........................................................

………………………………………………………………………………………………………………………………………………………………………………….. ,

and approximately earn ……….………………………………… THB/day

Previous scholarship

The applicant has never been received any scholarship.

The applicant previously received scholarships called ...........................................................................

for ...................................................................THB in ………………………………. (Year).

Governmental student loans (Latest year)

Student Loan Fund Academic year: .................................

Loan amount: ...............................................THB

Income Contingent Loan (ICL) Academic year: ..................................

Loan amount: ...............................................THB

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Extra curriculum activities

- Academic activities........................................................................................................................................... ............................

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- Public interests activities ................................................................................................................................. ..........................

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- Athletic activities........................................................................................................ ..................................................................

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- Other activities ................................................................................................. ............................................................................

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Persons able to provide more information related to the applicant (e.g. – close friends/teachers/

relatives)

Name:.......................................................Relation toward the applicant: .............................................................................

House number:..................................................Village number:.......................Road:............................................................

Street:..............................................Sub-district:..............................................District:............................... ................................

Province:...............................................Postal code:.......................................Phone number:..... ..........................................

Mobile phone number:………………………………………………………………………………………………………………..

The applicant’s special talents

(E.g. – Thai or English typewriting, accounting, computer skills, art skills, etc.)

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The applicant’s heath condition

- Chronic disease Yes (Pleas identify)..................................................................... No

- Other problems that can affect the study ......................................................... .............................................................

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- Other problems

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Please describe the applicant’s family condition, and the necessity of the scholarship request. Please

draw the applicant’s house map on the back side of this form.

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Additional required evidences and documents.

1. Copies of the applicant’s middle school and high school transcript showing the GPAX(s) (Only for 1st

year students)

2. A copy of the current bachelor transcript showing the study results and GPAX (Only for 2nd - 4th year

students)

3. A copy of applicant’s house registration showing the domicile.

4. A copy of national ID/passport of the applicant

5. A copy of national ID of the applicant’s guardian

***All aforementioned copies must be certified that they are correct***

I hereby certify and assure that the information above is true.

....................................................................., the applicant

(...................................................................)

Date……………………………………………..…………….

Note

1. The applicant’s information shall be confidential. 2. Providing of fault information herein is illegal. 3. The applicant must hand-fill the form. The applicant shall not cross, scratch, or erase any text

herein without the person’s signature nearby the correction. The applicant is not allowed to use correcting fluid herein

4. The applicant may submit more additional documents for the consideration. 5. The applicant must submit the application form at the DBTM office, 6th floor, Faculty of

Architecture and Planning building, Thammasat University (Rangsit Campus). Applicants may also deliver the form and documents through EMS to the Program as the following address. Design, Business, and Technology Management Project (DBTM) Faculty of Architecture and Planning, Thammasat University 99 Moo 18, Pahonyotin Road, Klongneung, Khlong Luang, Pathum Thani 12121 (Put brackets on the envelop’s ccorner: Scholarship application)

6. The application form must be sent by July 22nd, 2020

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Income Guaranty of the Applicant’s Family

Design, Business and Technology Management Program (DBTM)

Faculty of Architecture and Planning, Thammasat University

Date…………………………………………………………...

I am guardian (which is not parents) of Mr./Ms./Mrs.............................................................................................., Who is working as (occuparation)............................................................................................................................. .................... Workplace:.................................................................Number:.............Street:........................District:.......................................... Mr./Ms./Mrs......................................................... , father/mother of Mr./Ms./Mrs......................................................, is working as......................................................................................................................................... ............................................. Workplace:.......................................................................................Number: ..................Street:.................................................. Sub-district: ...........................................District: ......................................Province/ Country: .................................................. Phone number:.................................................... Yearly income:....................................THB Necessary reasons and necessities of the scholarship application ............................................................................................................................. ................................................................................................................................................................................................................................................................ ................................................................................................................................... ....................................................................................................................................................................................................................................... .............................................................................................................................................................................................................. ........................................................................... ................................................................................................................................... ................................................................................. ........................................................................................................................................................................ ................................................................................................................................... ............................................................................................. ................................................................................................................................................. ................................................................................. I hereby guarantee and assure that the information above is true. ........................................................ ............... (........................................................) Note

1. The applicant’s information shall be confidential. 2. Providing of fault information herein is illegal. 3. The guaranteeing person must hand-fill the form. The guaranteeing person shall not cross,

scratch, or erase any text herein without the person’s signature nearby the correction. The guaranteeing person is not allowed to use correcting fluid herein.

4. The applicant may submit more additional documents for the consideration.