1. Family Name/s:
2. First Name/s:
3. Citizenship/s (Attach Evidence):
4. E-mail Address:
5. Current Residential Address:
6. Postal Address (if not as above):
7. Business Phone: 8. Home Phone:
9. Date of Birth (day/month/year): 10. Place of Birth (City & Country):
11. Details of Accompanying family members (Please note – there are no additional allowances for accompanying dependents):
Full Name: Relationship to you: Date of Birth (day/month/year):
New Zealand International Doctoral Research Scholarship
Funded by the New Zealand Government
Administered by Education New Zealand
Application Form
All candidates are required to read the Frequently Asked Questions document before completing this form. The FAQ is available in pdf format from www.newzealandeducated.com
Country of Citizenship: ………………………………………………………
Office use only:
Eligible/Ineligible Complete Shortlist Y/N Notes Meets English Y/N Supervisor Conf. Y/N Offer of Place Y/N F/C
B. EDUCATIONAL QUALIFICATIONS & INTERESTS
12. What Field of Study/Discipline will your proposed PhD be undertaken in:
13. Tertiary academic qualifications undertaken. Include any currently underway beginning with the most recent (please attach an academic transcript of your results completion/graduation certificates to support this):
Name of Qualification Field of Study Name of Institution and location of campus Completion date (month & year)
14. Prizes, Scholarships, other professional honours:
15. Relevant publications, papers and titles of theses submitted for any degree: attach separate page if required.
16. Membership of cultural, scientific, professional and educational societies or organisations:
C. EVIDENCE OF ENGLISH LANGUAGE PROFICIENCY FOR CANDIDATES FROM NON-ENGLISH SPEAKING COUNTRIES
17. Applicants applying to undertake research in New Zealand who are from a non-English speaking country must meet one of the