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Application for APOST Educational Scholarship

TERMS & INSTRUCTIONS


1. Please turn in completed application, with all applicable information and signature,
to applications@apost-ent.org.
2. Priority of the scholarship is given to candidates from developing countries
suggested by WHO.
3. Successful candidates are required to edit a video for a procedure in the course and
write a short description on the essence of the procedure in practice. The output
should be deemed acceptable to the course faculties before the scholarship is
offered.

PARTICULARS

Course Applied: ________________________________________________________________________________

Applicant First Name: ________________________________ Last Name: _____________________________

Country: ____________________________________ Date of Birth: ______________________________________

Affiliation: __________________________________________ Position: ___________________________________

Email address: _____________________________________ Phone number: ___________________________

I, ________________________________________, hereby acknowledge that I have read, understand


and agree to the terms of this document.

Signature of Applicant: ____________________________ Date: _______________________________________

FOR INTERNAL USE ONLY

Application Status: Accepted/ Rejected (Delete as appropriate)


Approved by: ______________________________________
Position: ____________________________________________

_________________________________________________ ________________________________________________
Signature Date

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