Application form for UCM Scholarship

All students seeking financial assistance from University College Maastricht must complete this form.

To be uploaded before January 5th, 2018 together with your UCM application.

The UCM Scholarship is aimed at highly talented students from outside the EEA (European
Economic Area) who wish to follow the Liberal Arts & Sciences programme at University College Maastricht.

1. Personal Information

Surname
First name
Date of birth
Place of birth
Nationality
Gender Female Male
Address (postal address)
Zip code & City
Country
Telephone Home Mobile
Email

2. Family Information

Fathers name
Occupation
Employer
Nationality

Mothers name
Occupation
Employer
Nationality

Parents marital status

3. Parental Financial Information

All applicants requesting financial assistance are required to complete this section even if financially
independent from parents. Please provide official documentation of financial situation, such as recent
(parental) tax return and/or a copy of last pay check(s).

Parents or guardians combined gross annual income

Number of dependent children whose tuition will be paid
4. Other scholarships

Have you applied for any other scholarships? Yes No

Have you received a decision concerning these applications? Yes No
If yes, have you been awarded a scholarship? Yes No
If yes, please name the scholarship
Total amount of this scholarship
Name of institution granting the scholarship
Country of institution granting the scholarship

5. Explanation and comments

If you have other information that might be pertinent to this application for financial assistance, please
indicate this below.

6. Required signature

I hereby apply for the UCM Scholarship and declare that I have completed this form to the best of my
knowledge.

Date
Place
Signature of the applicant