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www.nesoindonesia.or.

id
Menara Jamsostek 20th floor,
Jl. Gatot Subroto no. 38, Jakarta 12710
p +62 (0)21 5290 2172
f +62 (0)21 5290 2173

APPLICATION INFORMATION
A. INSTRUCTIONS FOR THE APPLICANT:
Answer questions 1 through 10 clearly and completely, in English or Indonesian, typewritten. Do not change the
lay out of the original form.
You may submit one application only. Submiting more than one application leads to disqualification.
There will be no correspondence about submitted forms.
If at any time after award of the scholarship it becomes clear that the applicant has made inacurate or incorrect
declarations in the application, the scholarship offer will immediately be revoked.
All decisions concerning the application are binding and confidential. Queries, remarks or complaints regarding
selection issues will not be responded.
THREE SETS (1 original + 2 copies) of the application form and documentation are required.

B. ENCLOSURES:
Attach only certified copies of documents. Do not attach original documents, application form and
documents will not be returned.

Copy SK for government officials and lecturer of state universities or kontrak kerja for others;
Copy of original TOEFL prediction test of a recommended testing institute in your neighbourhood;
Curriculum vitae (see format CV at www.nesoindonesia.or.id);
Legalized copies of original diplomas and transcripts;
Legalized copies of translated diplomas and transcripts;
A personal and original letter of recommendation on letterhead referents office (Kop surat pemberi referensi);
Copy of KTP;
Copy of Kartu Dinas Pegawai Negeri for government officials and lecturers of state universities;
3 recent photographs (3x4; colour).

The closing date is 1 August 2008.


Applications received after 1 August 2008 and incomplete applications will not be processed.
Three complete copies of application form should be sumbitted. Completion in stages is not possible.
The earlier you send in your application the sooner you will know the outcome

C. PROSEDUR SELEKSI
Jadwal di bawah ini dapat berubah sewaktu-waktu.
1 15 Agustus

Seluruh aplikasi akan diperiksa kelengkapannya, dan kemudian dimasukkan ke dalam database.
Aplikasi yang tidak lengkap tidak akan diproses.

15 30 Agustus

Tim pembaca/penilai (Readers Team) akan melakukan penilaian atas motivation statement
terhadap kriteria-kriteria yang berlaku dalam program beasiswa ini. Kriteria difokuskan pada
aspek tujuan program dan kemampuan pelamar untuk menjabarkan komitmennya terhadap
pembangunan Indonesia.

September

Berdasarkan persyaratan StuNed dan penilaian-penilaian yang dilakukan, dihasilkan daftar


kandidat yang memenuhi persyaratan untuk kemudian diserahkan kepada komite seleksi. Seleksi
yang dilakukan menghasilkan sejumlah kandidat.

Oktober

Kandidat akan menerima surat provisional award yang menyatakan bahwa beasiswa akan
diberikan untuk tahun akademik 2009 apabila kandidat telah berhasil memenuhi seluruh
persyaratan StuNed, termasuk lulus wawancara. Provisional award ini berlaku selama 2 tahun.
Kandidat juga akan menerima surat dengan daftar persyaratan yang masih perlu dilengkapi.

Okt Feb

Para kandidat meningkatkan kemampuan berbahasa Inggris.


Kandidat mendaftar ke salah satu universitas di Belanda (lihat petunjuk lengkap di website);
Mengikuti tes ITP TOEFL (lihat lokasi penyelenggara tes di website).

Maret

Melengkapi dokumen persyaratan lainnya.

Mei

Kandidat terpilih akan dihubungi untuk diwawancarai di kantor pusat NESO Jakarta, di
daerahnya atau melalui telepon. Pada sesi wawancara ini kemampuan berbahasa Inggris dan
kualifikasi lain dari para kandidat akan dinilai. Apabila kandidat tersebut tidak memenuhi
kualifikasi StuNed, maka provisional award yang telah didapat tidak akan diberikan status
StuNed Award dan kesempatan diberikan kepada kandidat lain yang masuk dalam daftar
cadangan.

Mei - Juni

Hasil seleksi dan wawancara akan diberitahukan kepada semua kandidat. Kandidat yang
berhak atas beasiswa StuNed akan menerima surat melalui e-mail, yang berisi informasi
mengenai langkah selanjutnya, peraturan dan kebijakan, paket informasi mengenai Belanda,
informasi mengenai prosedur pembuatan visa serta asuransi untuk pelajar. Kandidat juga akan
diminta untuk menyerahkan hasil tes kesehatan.

Juni - Juli

Penerima beasiswa akan menerima surat beasiswa (StuNed Award Letter) setelah melengkapi
seluruh persyaratan yang diperlukan.

Juli

Penerima beasiswa akan diundang untuk menghadiri pre-departure briefing sebelum


keberangkatan di Jakarta. Bagi mereka yang bertempat tinggal jauh dari Jakarta, akan
diundang ke kantor NESO sebelum keberangkatan.

PRE-REGISTRATION APPLICATION FORM


MASTER PROGRAMME 2009

Please attach
a recent
photograph
3x4

TO BE FILLED IN BY APPLICANT
name:
male

female

FOR OFFICIAL USE ONLY


Region:

KTP / NIP:

BO

SM

UN

WK

BC
JU
JKT
NJ

email:

GPA:

S1

GPA MAX

English proficiency:
toefl
cbt
ielts
itp
non itp
non ielts
others

S2
GPA MAX

TOEFL / IELTS:

test date:

TEST CENTRE:
Satisfy criteria:
1.
complete form
yes
no
2.
age
yes
no
3.
employer statement
yes
no
4.
study abroad
no
yes

chosen programme:
university in NL:
duration:

months

selection:

employer:
(name of institution)

1.

>2Y

city:

2.

HWK

3.

CBC

4.

CSC

prov.:
employed since:
applicants position:
(specify)
position held since:

5.

Assessment:

PRE-REGISTRATION APPLICATION FORM


MASTER PROGRAMME 2009
Please note that any false and/or incomplete declaration will lead to the termination of the StuNed
scholarship. It is not allowed to extend or change the available space for each question, except for
question 6.
1. PERSONAL INFORMATION
All data exactly as they ( will) appear in your passport !

Name
Place/Date of Birth
Marital Status
Email Address
NIP for Public Sector Applicant

Male
Place:
Single
1.

Married

Date:
Children
2.

Female

Home Address

Telephone / Fax / Mobile


* obligatory

Home *:

Passport number

Nr.

Mobile Phone *:
Date of issue:

Parents address
(or next of kin)
Telephone / E-mail

Date of expiry:

2. THE COURSE YOU ARE INTERESTED IN

Name of university
Study programme
Period of this course

From:

Until:

Duration :

months

Name of contact person / email


Total tuition fee for this course

EUR

Minimum TOEFL / IELTS


requirement for this course

3. EDUCATIONAL RECORD
a.

Elementary School (SD)

Type of school
Name of school
City and Province
Year of graduation

b.

Junior High School (SMP)

Type of school
Name of school
City and Province
Year of graduation

c.

Senior High School (SMA)

Type of school
Name of school
City and Province
Year of graduation

d.

Undergraduate Education

Please enclose certified copies of relevant diplomas, degrees, certificates and transcripts.

Name, place, country of


institution
Field of study
Diploma or degree obtained

S-1 (or equivalent)


5

Year of graduation ..

e.

Postgraduate Education & Training

Please enclose certified copies of relevant diplomas, degrees, certificates and transcripts.

Name and place of institution


Duration

From:

Until:

Main field of study


Diploma or degree obtained

S-2

Masters Degree

Other

4. FOREIGN LANGUAGE ABILITY


A. Attach the latest TOEFL prediction test. Please keep in mind that for the actual registration you must provide an
International TOEFL certificate (CBT) with a minimum score of 213, or an Institutional ITP-TOEFL certificate (see
NESO Website for accepted test sites) with minimum score of 550, or IELTS with minimum score of 6. Please note that
not all "TOEFL Tests" are accepted (see www.nesoindonesia.or.id ). For postgraduate courses in the Dutch language
sufficient proof of your Dutch language skills must be provided.

English:
Dutch:
Others:

excellent
excellent
...

good
good

B. What are you doing to enhance your English?

fair
elementary
fair
elementary
.

not at all
.

5. PRESENT EMPLOYMENT
Name of Institution / Company /
Organisation
(Faculty/Department)
Brief description of the
company and the service it
provides

Type of organization

1. Central Government
2. Local Government
3. State University
4. Private University
5. Media
6. Non-Governmental Organization (NGO)
7. Other Educational Institute
8. BUMN
9. Private Company
10. Others
Telephone:
Fax:

Address
E-mail Address:
Website:
Employed Since (dd/mm/yy)
Present position

Employment for

Describe your current duties and


responsibilities
7

hours a week

This position held since


(dd/mm/yy)

6. MOTIVATION STATEMENT
The statement should be typewritten and composed only by the applicant him/herself. If possible in English, if not
answer in Bahasa Indonesia. If more space needed expand space until maximum 2 pages. Start question number 7 on
new page.

No.

Criteria

Explanation

Explain in 50 words which


experiences/considerations contributed
to the choice of your former study.
A.
Jelaskan dalam 50 kata mengenai
pengalaman/pertimbangan dalam
memilih program studi sebelumnya (S1)

Explain in 50 words which


experiences/considerations contributed
to the choice of your current job
B.
Jelaskan dalan 50 kata mengenai
pengalaman/pertimbangan dalam
memilih bidang pekerjaan saat ini.
Explain in 100 words the relevance of
the chosen program to the current
development of your organization (long
term development plan) and the sector
you work in.
C.

Jelaskan dalam 100 kata keterkaitan


antara program studi yang dipilih
dengan pengembangan
institusi/perusahaan (rencana
pengembangan jangka panjang) dan
bidang kerja saat ini.

Describe in 100 words how the chosen


study will benefit Indonesia in general.
D.

Jabarkan dalam 100 kata bahwa


program studi yang dipilih akan
bermanfaat bagi Indonesia secara
umum.

E.

Describe in 50 words which


job/position you expect to hold in ten
years time.
Jabarkan dalam 50 kata mengenai
pekerjaan/jabatan yang diinginkan
dalam waktu 10 tahun mendatang.

Describe in max. 150 words things you


have done that prove you are the right
candidate for a StuNed scholarship.
F.

Jabarkan dalam maksimal 150 kata


mengenai apa yang telah Anda kerjakan
yang dapat membuktikan bahwa Anda
adalah kandidat yang tepat untuk
memperoleh beasiswa StuNed

7. MISCELLANEOUS
How did you find out about the StuNed
Scholarship Programme FOR THE VERY
FIRST TIME?
(please take time to fill in this question, to
enable us to develop the best promotion
strategy)

(TICK ONLY ONE ITEM)

NESO Website
NESO Presentation (please indicate ...............................)
Article in print media (please indicate )
Advertisement in print media (please indicate ..)
Radio (please indicate)
Holland Education Fair (HEF)
Your Institution
Friends

Where/How did you get the information


about STUDY PROGRAMME for which
you apply?

Did you attend the StuNed Presentation in


your region?

StuNed alumnus

StuNed brochure/poster
NESO office in Jakarta/Surabaya
Others (please Indicate .....................................)
(TICK ONLY ONE ITEM)
List of Courses on the NESO website
Holland Education Fair (HEF)
Nuffic Website
University Website
Friends
Your Institution
NESO office in Jakarta/Surabaya
Others (please indicate................................................................)
No
Yes:
University
9

BAPPEDA/PEMDA

YEAR:
CITY:

Have you applied for StuNed Scholarship


Programme before?

No
Yes, year ..

List the countries you have visited, for which


period and for what purpose.

Are you in good health and fit for studying


abroad?

8. FUNDING
Have you ever been awarded a scholarship?

Yes

If so, from which organisation?

For what period, for which course/institution


and in which country has it been granted?

For which other scholarship programme(s)


are you also applying at this moment?

9. LIST OF ACTIVITIES, ACHIEVEMENTS, PUBLICATIONS, AWARDS

Social Activities

Achievements

Publications

Awards

Other (if any)

10

No

10. APPLICANTS DECLARATION

I certify that all my answers are true, complete and correct.


Date

Name

Place

Signature

THE ORIGIONAL APPLICATION FORM AND ITS ANNEXES TOGETHER WITH A COMPLETE
COPY SHOULD BE SENT TO:

NESO INDONESIA
Menara Jamsostek 20th floor
Jalan Jend. Gatot Subroto no.38
Jakarta 12710

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