Application form UM High Potential Scholarship Please send this scholarship application form to the Faculty contact person at Maastricht University before 1 March 2012. The High Potential Scholarship aims at highly talented students from outside the EU/EEA who wish to follow a Master’s programme at Maastricht University.

Please enclose the following documents: Curriculum vitae. Two letters of reference from an educational institution or an employer in your home country. Motivation letter regarding the application for the High Potential Scholarship and the Master’s

programme. Photocopies of relevant diplomas and transcript of records.

1. Personal information Surname: ........................................................................................................................ First name: ........................................................................................................................ Date of birth: ........................................................................................................................ Place of birth: ........................................................................................................................ Nationality: ........................................................ Gender: Female Male Postal address: .................................................................................................. Zip code & city: ........................................................................................................................ Country: ........................................................................................................................ Telephone: ........................................................................................................................ Email: ........................................................................................................................

MAASTRICHT UNIVERSITY

Maastricht University aims to further strengthen its position as a leading European University offering high quality education with an international orientation. To this end, the University implements a proactive recruitment policy for international students, in particular for the Master’s programmes. Within this framework, the High Potential Scholarships are made available by Maastricht University Scholarship Fund in order to encourage talented students from outside the EU/EEA to follow a Master's programme at Maastricht University (including research Master’s programmes and Master’s programmes not funded by the Dutch government).

2. Programme at Maastricht University Name of the programme: ..............................................................................................................

One-year Master’s programme

Two-year Master’s programme Student ID number at Maastricht University …………………………………………………………………………………………………………………. 3. Other scholarships Have you applied for other scholarships? Yes No Have you received a decision regarding the scholarship application(s)? Yes No If yes, have you been awarded a scholarship(s)? Yes No If yes, Name of the scholarship(s): .......................................................................................................... Total amount of the scholarship(s): € ........................... 4. Home institution Name: ........................................................................................................................ City and Country: ........................................................................................................................ 5. Signature I herewith apply for the High Potential Scholarship and declare that I have completed this form to the best of my knowledge. I declare that I have taken notice of the rules and regulations of the High Potential Scholarship. If I will be awarded a High Potential Scholarship, I will respect these conditions. Date ................................................ Place ................................................ Signature ...........................................................................................................