Part 1 (Mandatory)

Financial Aid Application (AY 2017-18)

PART 1 (MANDATORY)

Name and Last Name: ASE Degree Program: Nationality:

Gender: Marital Status:

Email: Telephone: Address:

Current Occupation (include name of organization/institution/company):

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Spouse Information

Spouse Name and Last Name:

Current Occupation (include name of organization/institution/company): Spousal Income (annually):

Dependent Information

Number of Dependents:

Name of Dependents Age Relationship Additional Information

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Parental / Guardian Information

3.1) FATHER

Father’s Name and Last Name: Living or Deceased: Married, Separated, Widowed: Father’s Age: Father’s Education Level (Primary School, Secondary School, University Degree):

Current Occupation (include name of organization/institution/company): Father’s Annual Income:

Number of Father’s Dependents:

3.2) MOTHER

Mother’s Name and Last Name: Living or Deceased: Married, Separated, Widowed: Mother’s Age: Mother’s Education Level (Primary School, Secondary School, University Degree):

Current Occupation (include name of organization/institution/company): Mother’s Annual Income:

Number of Mother’s Dependents:

3.3) GUARDIAN (if someone other than applicant’s Parents will pay tuition fees)

Name and Last Name: Living or Deceased: Married, Separated, Widowed: Age: Education Level (Primary School, Secondary School, University Degree):

Current Occupation (include name of organization/institution/company): Annual Income:

Number of Dependents:

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Sibling Information

Number of Siblings:

Name Age Relationship Special Information

Additional Family Information

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Applicant’s Financial Information

Annual Income

Wages/Salaries from Employment (total)

Income from Business: Income from Farming: Income from Real Estate: Income from Other Investments (specify):

Other Additional Incomes (specify):

Savings and Assets

Cash Savings: Securities: Value of Assets (Business, Home, Real Estate, Farm): Other Additional Savings:

Annual Expenses

Annual Household Expenses:

Medical Expenses (nonrefundable):

Loans and/or Debts:

Annual School/University Fees for Dependents:

Additional Expenses:

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Essay Questions

If applicable, please identify who or what institution/organization will support/assist in funding your education at ASE (250 words, approximately a half page).

Please describe what steps you have taken to fund your studies at ASE. List any external scholarships, fellowships, grant applications, or other requests for assistant (250 words, approximately a half page).

Please describe why you require financial aid from the African School of Economics. It is important to demonstrate financial need and worthiness based on your character and potential. Your essay may describe: challenges you have faced, obstacles you have overcome, special circumstances, or any other elevant topic.

www.africanschoolofeconomics.com 6 Agreement and Signature By submitting this application, I affirm that the facts set forth in it are true and complete. I understand that if I am accepted in the work-study program, any false statements, omissions, or other misrepresentations made by me on this application may result in my immediate dismissal.

Signature

Submission instructions Please complete this form and submit it by email to [email protected] (with copy to Mrs. Clementine Assede, [email protected]).