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WELLS MOUNTAIN FOUNDATION

2012 SCHOLARSHIP APPLICATION (Scholarship Application due April 1, 2012)

The Wells Mountain Foundation is a public charitable foundation based in Bristo l, Vermont, USA, which has been approved under the United States Internal Revenue S ervice under Section 501(c)(3). The purpose of the Foundation is primarily to support p rograms and individuals in developing nations or other situations of extreme poverty.

Each year the Foundation s Empowerment Through Education program provides support to a number of students as they pursue various educational objectives. S upport is provided for post-secondary school (college, university, polytechnic, trade scho ol). Support is not provided for graduate degrees or study in the US, UK or other developed coun tries. Financial support is primarily to cover the costs of the education itself and di rectly related expenses including boo s and supplies.

Scholarships are generally granted for the full period of study, however, recip ients must maintain good grades and provide copies of all semester reports and grades as th ey are received. The scholarship can be discontinued at any time in the event of unsati sfactory performance.

The scholarship awards are determined by the Scholarship Committee of Directors of the Wells Mountain Foundation and awarded once a year. must be received by April 1, 2012 to be considered for the 2012-2013 school ants will be notified if they have been selected as a WMF Scholarship student tely August 1, 2012, with funding for the first semester by September 1. All applications should be mailed (our first choice) or e-mailed to:

Wells Mountain Foundation, Inc.

of the Board Applications year. Applic by approxima

25 D Main Street Bristol, Vermont 05443 USA Or wmfscholars@wellsmountainfoundation.org

Family Name: (Family Name) UR RAHMAN

Given Name: (Given Name) HAMID

What do you li e to be called: (What do you li e to be called) HAMID

Date of Birth: (Date of Birth) Apr-14-1990 Social Security # or Equivalent: (Social Security # or Equivalent) 16101-3689760-1 (If you have no equivalent in your country, attach a copy of proof of citizenshi p or ID Card)

Address: (Address) H#A-1 SHEIKH ZAYED ISLAMIC CENTRE COLONY UNIVERSITY CAMPUS _

City: (City) PESHAWAR Region/State/Province: (Region/State/Province) KHYBER PUKHTUNKHWA Country: (Country) PAKISTAN

Telephone: (Telephone) +92915600987 Mobile Telephone:

(Mobile Telephone) +923139858792

E-Mail Address: Please print clearly or type!! (E-Mail Address: Please print clearly or type) hamidicup@hotmail.com _

Attach your photo here

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Name, Address, Telephone Number, and E-mail Address of the closest living relati ve (i.e. mother, father, spouse, grandparents, uncle, aunt, etc): (mother, father, spouse, grandparents, uncle, aunt, etc [3]) (mother, father, spouse, grandparents, uncle, aunt, etc [2]) email:saeed@aw um.e du.p , Uncle-Miraj-Ul-Islam Zia, e-mail: mirajzia@yahoo.com (mother, father, spouse, grandparents, uncle, aunt, etc [1]) Elder Brother -Saee d Ur Rahman,

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Proposed Program of Study:

What do you plan to study subject and degree level? (What do you plan to study subject and degree level [2]) (What do you plan to study subject and degree level [1]) Zoology-Bachelors Degre e

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Where do you plan to study name of school and location (city and country)? (Where do you plan to study name of school and location (city and country) Islam ia College University Peshawar Pa istan Total duration of the program through a degree or certification? (Total duration of the program through a degree or certification) 04 years

Have you been accepted to this program yet?

(Have you been accepted to this program yet) Yes _

If no, when do you expect to receive a letter of acceptance? (If no, when do you expect to receive a letter of acceptance)

If you are just beginning this program, what date will your studies begin? (If you are just beginning this program, what date will your studies begin)

If you are in this program and attending classes, how many years have you finish ed? (If you are in this program and attending classes, how many years have you finis hed) 03 Years

What month and year do you expect to graduate? (What month and year do you expect to graduate) January 2013

How many total years will you be in the program? (How many total years will you be in the program) 04 Years

Your Financial Resources:

Do you have any prospects for employment part-time or otherwise while you are in school or between semesters, when you can earn income towards your educational costs? (between semesters, when you can earn income towards your educational costs [2]) as ed my uncle to pay my fee but nowa days it is very difficult for him to affo rd my education expenses. (between semesters, when you can earn income towards your educational costs [1]) No I don't have any prospects, i tried a lot to find some resources to pay my f ee but did'nt find one. I then

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Our maximum scholarship is $3000, but we rarely award that high an amount. If we provide less than the total amount you have as ed for in this scholarship application, i s there any way you can ma e up the difference, if so how much? (If your costs exceed $3000 and you have no other way to ma e up the difference, then you should not apply for this scholars hip.) (other way to ma e up the difference, then you should not apply for this scholar ship [2]) wor ing 4 hours more for 5 months. But he is now old and i feel shy by as ing him. (other way to ma e up the difference, then you should not apply for this scholar ship [1]) If you award me less than the amount mentioned then my uncle has to do something as he do normally

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What is your best estimate of the costs for your program for one school year? Pl ease do not over-estimate your financial costs.

Local currency U.S. Dollars (Be sure to convert the costs) (Be sure to convert the costs) 327

Tuition: ([1]) 30,000 _____________

School fees: ([2]) 10,000 _____________ ([1]) 110

Cost of room: ([3]) 5400 ______________ ([2]) 60

Supplies: ([4]) 25,000 ______________ ([3]) 271

Other: (please specify) (Other: (please specify [2]) GAS, ELECTRICITY (Other: (please specify [1]) FOOD ([5]) ______________ ([4])

______ ([1]) 42000 ______________ ([1]) 457

_____ ([2]) 20,000 ______________ ([2]) 217

Total: (undefined) 107400 ______________ (undefined) 1171

About You:

Please list and describe prior educational experience including schools you have attended and graduated from, and the course of study. Do not include primary schools. (graduated from, and the course of study. Do not include primary schools [2]) fr om Govt. High School Gujrat Mardan, and HSSC from AUPS & C (graduated from, and the course of study. Do not include primary schools [1]) I got admission in eighth class in the Govt. High School Baru Banda Mardan, I done my SSC(science)

Please list and describe all employment experiences: (Please list and describe all employment experiences) I don't have.

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Please list any volunteer activities that you have been involved in. (Please list any volunteer activities that you have been involved in [2]) and al so a member of Blood donor society (Please list any volunteer activities that you have been involved in [1]) I am t he president of Biodiversity & Environmental Conservation Society (BECS) Islamia college pesh.

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Tell us what you plan to do after you complete your education including where yo u hope to live? (Tell us what you plan to do after you complete your education including where y ou hope to live [2]) educated strong nation. (Tell us what you plan to do after you complete your education including where y ou hope to live [1]) After completing my education i want to leave here in my co untry and want to serve my nation to build an

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Documents that you must include with your application:

We will not consider incomplete applications!!

.. A brochure or other information on the educational institution that you propo se to attend. Do not just give us the school s website, although you may print out info from the site and included it with your application. We have some brochures on file in our office. If you plan to attend any of the following, it is not necessary to send a brochure: Kampala Int ernational U., Port Harcourt U., Aga Khan U., Bugema U., Ta oradi Poly, Niger Delta U., U. of C ape Coast, Kwame N rumah U., Haramaya U., U. of Ghana, Ma erere U., and Gulu U., as we have copies of their catalogs on file in our office.

.. A letter of acceptance from the school, if you have already received one. If not, send it to us once you have been accepted, noting that you have already sent in an applicat ion.

.. Two letters of recommendation from people who now you, but are not family me mbers, such as employers, teachers, clergy, volunteer group leaders, etc., who can tell us about your character and abilities.

.. A personal statement of at least 500 words, telling us about your bac ground, your family, your life experiences, why you chose to study the particular field you are study ing, and why you believe you should be favorably considered for this scholarship. This statement is a very important part of our decision ma ing process!

.. Official transcript of grades from secondary school with a ey to interpretin g the grades. For example, in some countries D means below average and in others it stands for D istinction. If you have already completed one or more years at the tertiary level, please in clude an official grade report for these studies. Do not include grades from primary or junior hig h school.

Please chec

off these items to be sure you have included them.

Please only send in your application once. We will send you an email ac nowledge ment when it arrives in our office. If you do not receive an ac nowledgement after two wee s, email us and as if we have received it before you send another copy.

Volunteer Service

The Wells Mountain Foundation is committed to the importance of volunteer servi ce. We believe volunteer service provides benefits not only to the cause where the t ime is expended, but also to the volunteer. Applicants for a scholarship should be advi sed that an award of a scholarship will come with a requirement for some period of volunteer activity by the scholarship recipient at a non-profit organization or school in your country or near your school.

I hereby certify that all of the information provided here and in the attached documents is accurate and that this application is complete.

_________________________ (text) Applicant (Date) Apr-27-2012 Date

(Email address) hamidicup@hotmail.com Email address

.. Results from your national exam, if your country gives this xamination.

ind of student e