stuned form (master program)

7/28/2019 StuNed Form (Master Program)

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www.nesoindonesia.or.id

Menara Jamsostek 20th floor,

Jl. Gatot Subroto no. 38, Jakarta 12710

p +62 (0)21 5290 2172

f +62 (0)21 5290 2173

APPLICATION INFORMATION

MASTER PROGRAMMEA. INSTRUCTIONS FOR THE APPLICANT:

Answer questions 1 through 8 clearly and completely (in English, typewritten). Do not change the lay out of the

original form.

You will receive confirmation of receipt of your application within 2 weeks after the deadline by e-mail.

You may submit one application only (apply for one course only). Submiting more than one application (more than

one course) leads to disqualification.

The selection will be held in May 2012 and the result will be announced to the applicants at the latest by end of

June 2012.

Failure to react to Nesos correspondence/e-mail within 48 hours can lead to cancellation of the scholarship.

If at any time after award of the scholarship it becomes clear that the applicant has made inacurate or incorrectdeclarations in the application, the scholarship offer will immediately be revoked.

ONE SET of the application form and documentation are required.

Application form and documents will not be returned.

B. ENCLOSURES:Attach only certified copies of documents.

Admission letter by Dutch Higher Education Institution in the Netherlands;

Certificate of `TOEFL Internet-Based Test Examinee Score Report minimum 80 or `International English

Language Testing System Test Report Form (IELTS Report Form) minimum score 6;

Curriculum vitae, see format on website www.nesoindonesia.or.id; Copy SK for government officials or kontrak kerja for others;

Legalized copies of original diplomas and transcripts;

Legalized copies of translated diplomas and transcripts;

Copy of KTP or copy of passport

One recent photograph (3x4; colour)

The closing date is 15 March 2012

Applications received after the closing date and incomplete application will not be processed.

One complete set of application form should be submitted. Completion in stages is not possible.

C. SELECTION PROCEDURE

Mar-Apr 2012 All applications are checked on their completeness. Incomplete applications will not be

processed. Candidates who disqualify during this stage will receive a written notice.

Based on the formal StuNed criteria a list of eligible candidates is composed for the final

selection. This selection will result in a number of selected candidates and a ranked list of

reserve candidates. If among the final selection some candidates refuse or are not able to

receive the scholarship, candidates on the ranked reserve list will be awarded the scholarship.

May 2012 Selected candidates will be notified through a letter via e-mail, conveying extensive

information about procedures to be followed-up, the Rules and Regulations of the StuNed

Scholarship programme, a package with information about the Netherlands and information

about the visa procedure.

Jul 2012 Awardees will be invited for a pre-departure briefing in Jakarta.
http://www.nesoindonesia.or.id/http://www.nesoindonesia.or.id/


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APPLICATION FORM

MASTER PROGRAMME 2012

TO BE FILLED IN BY APPLICANT

name :

male female email 1 :

email 2 :

FOR OFFICIAL USE ONLY

Documents Y N

1 recent photograph

Employer Statement

Applicant's Declaration

Admission Letter

IBT/IELTS

CV

SK

Original Diploma

Translated Diploma

Original Transcript

Translated Transcript

KTP or Passport

Eligibility Y N

Admission Letter

Chosen Programme

Tuition fee

GPA

Full Time / Part Time

2 years working exp.

IELTS/IBT score

Selection Score

Partner

MIB

F / M

Java / Outside Java

Score

Final Result Y / N

Scholarship Award

GPA: S1 S2

GPA MAX GPA MAX

IBT / IELTS: test date:

chosen programme:

university in NL:

duration: months

employer:

(name of institution)

city:

province:

employed since: dd/mm/yyyy

applicant position:

position held since: dd/mm/yyyy

2

Please attacha recent

photograph3 x 4

dd mm yy


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APPLICATION FORM

MASTER PROGRAMME 2012

Please note that any false and/or incomplete declaration will lead to the termination of the StuNed

scholarship. It is not allowed to extend or change the available space for each question, except for

question 5.

1. PERSONAL INFORMATIONAll data exactly as they (will) appear in your passport !

Name Male Female

Place/Date of Birth Place: Date:

Marital Status Single Married Children

Email Address 1. 2.

Home Address

Telephone / Fax / Mobile

* obligatoryHome *:

Mobile Phone *:

Passport number Nr. Date of issue: Date of expiry:

Parents address

(or next of kin)

Telephone / E-mail

2. THE COURSE FOR WHICH YOU HAVE BEEN ADMITTEDPlease enclose the admission letter of the Institution in the Netherlands.

Name of university

Study programme

Period of this programme From: Until: Duration : months

Name of contact person / email

Total tuition fee EUR

Minimum TOEFL/IBT / IELTS

requirement for this programme

3. EDUCATIONAL RECORD

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a. Undergraduate EducationPlease enclose certified copies of relevant diplomas and transcripts

Name of institution

Place of Institution

Field of study

Diploma or degree obtained S-1 (or equivalent) Year of graduation GPA.

b. Postgraduate Education & TrainingPlease enclose certified copies of relevant diplomas, degrees, certificates and transcripts.

Name and place of institution

Duration From: Until:

Main field of study

Diploma or degree obtained S-2 Masters Degree Other

4. PRESENT EMPLOYMENT

Name of Institution

/Company/Organisation

(Faculty/Department)

Brief description ofInstitution/Company/Organisati-

on and the service it provides

Address

Telephone:

Fax:

E-mail Address:

Website:

Employed Since dd/mm/yyyy

Present position

Employment for hours a week

Describe your current duties and

responsibilities

This position held since dd/mm/yyyy

5. MOTIVATION STATEMENTThe statement should be typewritten and composed only by the applicant him/herself.

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No. Criteria Explanation

A. Explain in 100 words the relevance of

the chosen study programme to your

personal and career development

B. Explain in 100 words the relevance of

the chosen study programme to the

current development of your

organization (long term development

plan) and the sector you work in.

C. Describe in 100 words how the chosen

study programme will benefit

Indonesia in general.

6. MISCELLANEOUS

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How did you find out about the StuNed

Scholarship Programme for the very first

time?

(TICK ONLY ONE ITEM) Nuffic Neso Indonesia Website

Nuffic Neso Indonesia Presentation at the Neso office

Nuffic Neso Indonesia Presentation at your office

Article in print media (please indicate )

Advertisement in print media (please indicate ..)

Radio (please indicate)

Holland Education Fair (HEF) / European Higher Education

Fair (EHEF) Your Institution

Friends

StuNed alumnus

StuNed brochure/poster

Nuffic Neso Indonesia office in Jakarta/Surabaya

Others (please indicate .....................................)

Where/How did you get the information

about the study programme for which you

apply?

(TICK ONLY ONE ITEM) List of Courses on the Neso website

Holland Education Fair (HEF) / European Higher EducationFair (EHEF)

Nuffic Website

Dutch Higher Education Institution Website

Friends

Your Institution

Nuffic Neso Indonesia office in Jakarta/Surabaya

Others (please indicate................................................................)

Have you ever attended the StuNed

Presentation in your region?

No

Yes: University BAPPEDA/PEMDA OtherYEAR:.. CITY:.

Have you applied for StuNed Scholarship

Programme before? No

Yes, year..

Have you ever been awarded a scholarship? Yes NoIf so, from which organisation?

For what period, for which course/institution

and in which country has it been granted?

For which other scholarship programme(s)

are you also applying at this moment?

7. STATEMENT BY THE EMPLOYER

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I, the undersigned, being authorised to supply

the following particulars hereby certifies that

Mr/Mrs/Miss.:

is employed by our organisation

and is applying for a StuNed scholarship to

follow a master programme in The

Netherlands in the field of / name of the

study programme :

Dutch Higher Education Institution

(University) in the Netherlands :

Name of Applicant:

Since:

Department:

Current Position:for hours a week

Position held since:

Please explain fully why the master

programme is important to your organisation

(and to the applicants work in the future) :

Do you guarantee that, if the candidates is

awarded with the scholarship, he/she will

continue to be employed by your

organisation after completion of her/his

study?

Which position will be offered to the

candidate after succesful completion of

her/his study?Department:

I certify that all my answers are true, complete and correct, and that if the candidate is awarded a StuNed scholarship,

my organization will comply with all the formal obligations this entails.

Name (of organization) :

Name (of contact person) :

Position :

Date :

Place :

Signature and official stamp : (please sign on materai)

8. APPLICANTS DECLARATION

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THE ORIGINAL APPLICATION FORM AND ITS ANNEXES SHOULD BE SENT TO:

Nuffic Neso Indonesia

Menara Jamsostek 20th Floor

Jalan Jend. Gatot Subroto No.38

Jakarta 12710

I completely understand the conditions under which the scholarship is offered, and if I am awarded a

StuNed scholarship I agree:

1. to comply with all the formal obligations mentioned in the Rules & Regulations of StuNed;

2. to return to my home country immediately after the programme has ended;

3. to be available for the entire period of the study programme and be able to take part in the entire programme;

4. to give permission to enter my personal data in a database which may be used at Nuffic Neso Indonesias

discretion to provide information for non- commercial purposes;

5. to abide by the rules and regulations governing the student visa and stay permit;

6. to fill in and submit end of course questionnaire;

7. to act in such a manner that will not bring disrepute or cause any formal damage to any party involved in the

programme including the host institution, the image of Indonesian students in the Netherlands, Nuffic Neso

Indonesia and accept to be called back to Indonesia without any formal appeal in case I breach this promise;

8. to participate in activities organised in relation to the StuNed scholarship during the programme and after I

have returned to Indonesia;

9. not to engage in employment in the Netherlands other than the allowed maximum of ten hours a week, and to

inform and update Neso of any details of such employment if any;

10. not to hold another scholarship that would give any overlapping benefit without Nuffic Neso Indonesias

written approval.

Furthermore:

11. I fully understand that if I am awarded a StuNed scholarship, it may be subsequently withdrawn if I fail to

make adequate progress, or for other sufficient cause determined by the Government of the Netherlands or the

institution at which I am studying.

12. If reports from the host institutions give reason to doubt a successful continuation of the study, the scholarship

may be terminated with immediate effect.

I certify that all my answers are true, complete and correct .

Date :

Name :

Place :

Signature :