TOTAL SCHOLARSHIP

Total E&P Indonesie will grant scholarship for 20 students from four State Universities (UI, ITB, UGM,
ITS), with different majors.

This program is considered as one of our commitment to develop human resources by giving a financial
support to Indonesian outstanding students.

The scholarship candidates should be in 5th or 7th semester, have good academic records with GPA min.
3.00, and also good English proficiency.

Total E&P Indonesie will conduct selection process together with the University. The grantees will be
entitled to receive Rp. 4.000.000,-/ semester for one year.

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 APPLICATION FOR SCHOLARSHIP

PERSONAL DATA
Photo
Full Name : 3x4 cm
MUHAMMAD HIFDHI NASRILLAH

Present Address : BUMI MARINA EMAS E 80 KEPUTIH SURABAYA - EAST JAVA

Permanent Address : SUNAN PRAPEN II AC NO.09 - KEBOMAS - GRESIK - EAST JAVA

Telephone : 0856 5521 9030

E-mail Address : Fedick_99@yahoo.com

Place & Date of Birth :

GRESIK, MARCH 10th,1988
Sex : MALE

Account Number : 011 682 3560

Bank Address :
BANK BNI BRANCH OFFICE URIP SUMOHARJO

FAMILY DATA
Name Age Education Occupation

Father Drs.ZAINAL ARIFIN 56 BACHELOR – S1 TEACHER

Mother NUR QOMARIYAH 41 SENIOR HIGH SCHOOL HOUSE WIFE

Sibling: 1 MUHAMMAD DANIAL 23 BACHELOR – S1 HEAD OF AREA

YASRILLAH
2
NUR HADZIQOTUL FAYIMAH 17 SENIOR HIGH SCHOOL STUDENT
3
FAHRUNNISA’I FATIMAH 15 JUNIOR HIGH SCHOOL STUDENT
4

EDUCATION BACKGROUND
Graduated/ Degree
School From - To Name & Location of School Major Course GPA
Received
Elementary 1996-2002 SD.MUHAMMADIYAH 1 GIRI - - 39,89

Jr. High 2002-2004 SLTP N 1 GRESIK - - 22,45

Sr. High 2004-2006 SMA N 1 GRESIK SCIENCE - 27,86

MATERIALS AND
University 2006-NOW ITS SURABAYA METALLURGICAL BACHELOR – S1 29,7
ENGINEERING

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ORGANIZATIONAL ACTIVITIES
Name of Organization/ Activities From - To Position

REMAJA MASJID SMA N 1 GRESIK 2003-2004 STAFF OF SOSIAL DEPARTMENT

OSIS SMA N 1 GRESIK 2003-2004 HEAD OF DEPARTMENT ISLAMIC

STAFF OF EDUCATION AND
BEM FTI ITS 2007-2008 WELLFARE DEPARTMENT
STAFF OF RESEARCH AND
HMMT 2007-NOW TECHNOLOGY DEPARTMENT

ASH-HABUL KAHFI 2007-NOW LEADER

TRAINING/ COURSE/ APPRENTICESHIP RECORDS

Kind of Training/ Course/
From - To Organized By Location
Apprenticeship

PUBLIC RELATIONSHIP FEBRUARY 18th, 2007 JMMI ITS SURABAYA

LEADERSHIP AND AUGUST 31st - SEPTEMBER
ORGANIZING TRAINING 1 2nd, 2007 BEM FTI ITS SURABAYA
BATAN ( NATIONAL
NON DESTRUCTIVE TEST
DECEMBER 2th - 24th, 2008 NUCLEAR ENERGY BANDUNG
(NDT BASIC LEVEL)
AGENCY )
AUTOCAD 2&3 D JANUARY 2nd - 30th, 2009 GAJAH MADA COMPUTER KEDIRI
STUDENT MANAGERIAL
SKILL TRAINNING DECEMBER 15th - 17th, 2006 BEM FTI ITS SURABAYA
SHELL LIVEWIRE BRIHT
IDEAS WORKSHOP NOVEMBER 20th, 2008 PT.SHELL INDONESIA SURABAYA

ACTIVITIES & HOBBIES

Membership of Professional
PM3I (ASSOCIATE INDONESIA STUDENT OF METALURGY AND MATERIAL)
Association

Hobbies & Sports FOOT BALL

Social Activities SOCIAL FIND VOLUNTEER

ADDITIONAL INFORMATION (if any)

The facts stated in this Scholarship Form are true and complete to the best of my knowledge and
belief.
I understand and agree to follow all the procedures, regulations, and requirements that related
to Total E&P Indonesie’s Scholarship Program.

Date: Applicant’s
Signature:

N.B: Please supply all of this documents, along with this form:
• Copy of academic transcripts, from 1st semester until the last semester.
• 1 photo (3x4 cm).
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• Copy of the first page of your account book (that stated the Bank’s name, your name and
account number).

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Date : MARCH 25th, 2009
Name : MUHAMMAD HIFDHI NASRILLAH

1. Why are you entitled to accept this scholarship?

I am entitled to accept this scholarship because

My father is a teacher in senior high school with a little salary. Only my father supports his children’s study with his

salary. Total E&P scholarship can help me to fulfill my daily need and continue my study in ITS. Beside that, I am

going to take a welding inspector. This program is exspensive. Therefore, this scholarship is very important for me.

I like organization. I have joined organization since I left junior high school. Now I am a leader in Islamic organization.

I get knowledge about soft skill (leadership, net work building, communication skill, negotiation skill and etc) from

organization. I can work well in a team or personal.

In hard skill, I can speak and write English well (active and passive English). Otherwise, I have Non-Destructive Test

(NDT) basic level certificate. So Total E&P company can use my competency to employee me as staff in inspection

field. I master a program autocad 2 and 3 dimension. This program use to design tools, pipeline and etc.

2. What is your planning after graduated from University?

when I graduated from university, I have two plans for my future.

1. As I know that Total E&P company has 2 scholarships, S2 at French and S2 in Department of Oil Engineering at

ITB.

If I have the opportunity to get one of Total E&P scholarship, I am going to continue my study be magister

engineering. Because I believe that this program will make my future better.

2. I am going to take a welding inspector program at B4T in Bandung. This competency is imperative for me.

Certificate of welding inspector is very important because every big company, specially Total E&P company

usually look for employer who has many work experiences. There for I can be part of them with this certificate.

And I believe that Total E&P company needs some welder.

But the main point of my explanation that I wish Total E&P company accept me to be its employer.

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