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3ity
Degree
Specialisation
Percentage $ 3%P5
1rganisation
Position
#re-ious or present study and stays a.road 'includin France( of at least t/o months0 duration
Period !mm/yyyy" -nstitution 3ity0 3ountry inanced by
8 &one
D.9 $ D59 e2amination 51
5:
#1
#:
31
3:
-f not D.9 $ D59 0 please specify ;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;; !school $ coaching classes $ self*taught or any other"
Peer $ Senior
3ampus rance
5lliance fran<aise
Statement of #urpose 'minimum one pa e4 ma"imum t/o pa es in 5imes Ne/ 6oman $ %)( Please highlight the reasons for choosing rance and the institution where you will be studying/ Please also e2plain why you would be a worthy candidate for the scholarship .
- hereby declare that the above statements are true to my knowledge and belief= that - am of sound health and not physically handicapped in a way that would prevent me from carrying out my pro(ect in rance/ The rench .mbassy has my permission to electronically store my personal data0 which is re)uired for my scholarship application and my possible stay in rance/ -f a scholarship is awarded to me0 my name and institution of origin may be included in lists published by the rench .mbassy in -ndia/ -f - am awarded a 3harpak scholarship of e2cellence0 - agree to become a >3harpak 5mbassador? of rench higher education when - return to -ndia/ This may involve taking part in one or two higher education events at the 5lliance ran<aise of my city0 or in one or two events organized by a 3ampus rance counsellor in my -ndian university$ institution of origin/
Place @ Date
Signature