IVYPREP TALENT SCHOLARSHIP APPLICATION FORM Please write down your information and your essay in the below sections. All your information will be kept strictly confidential. Deadline: 15/5/2018. Only shortlisted candidates will be contacted for the 2nd round if they meet enough criteria. 1 PERSONAL INFORMATION Fullname: .................................................................... Date of birth: ......../ ......./ ............ Nationality: ................................................................. Gender: □ Male / □ Female 2 CONTACT INFORMATION 2.1 Permanent home address: (House number) ....... (Street name) ...................................... (ward) ................................ (District/ Town) .............................. (Province/ City)..................... 2.2 Contact detail: Mobile:................................ Homephone: .................................... Email: ............................... 2.3 Parents Contact: Contact #1 Fullname: .......................................................... Relationship: ................................................ Mobile: ............................... Homephone: .................................... Email: ................................ Contact #2 3 ACADEMIC RECORDS High school: ................................................................................................................................ Address: (District/ Town) .............................. (Province/ City)................................................... Grade: ................................................... Grade Point Average (GPA): ....................................... English Point Average (EPA): .................................... Achievement: What award(s) have you achieved? At what places? □First prize □Second prize □Consolation prize □Others: ............................... IvyPrep Talent Scholarship - Thắp sáng tài năng

4 WRITE AN ESSAY In 250 words, please write an essay about your orientation and expectation in the upcoming 1-3 years, explain why you want to receive this scholarship: …………………………………………………………………………………………… More information, Please contact to: Website: www.ivyprep.edu.vn Facebook: Fb.com/IvyCollegePreparation/ Hotline: 091 121 8066 IvyPrep Talent Scholarship - Thắp sáng tài năng