Private Mail Bag, Govt Buildings, Suva. Telephone: (679) 9924131. Website: http://www.tslb.com.

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ADVISORY FORM
A

PERSONAL DETAILS

Title:
Mr.

Miss

Mrs

First Name

Student ID

Surname/Family Name

Residential Address
Current Postal
Address

Current Residential
address

Email

Phone Contact

PROGRAMME OF STUDY
Institution

Programme (Specify Majors if any)

Campus

Current Study Details

Current GPA:__________ (please attach transcripts/results for 2014 and for all years during which you are under this scholarship)

SCHOLARSHIP DETAILS

Scholarship Scheme
D

UNIVERSITY DETAILS

University Name &

Address
Name and Full Contact of
your Academic Advisor

BANK DETAILS (fill only this if you are entitled to an allowance as per your scholarship award)

Bank Name:

Bank Account No.

(attach copy of your bank statement for verification)

APPLICANT'S DECLARATION

I undertake to comply with the rules and regulations of the Students on Scholarship as per the terms and conditions of my award. I
declare to the best of my knowledge that all the information supplied with this application form is true and complete in all signific ant
particulars. I understand that making a false declaration is an offence.
Please ensure that all mandatory fields are completed.
Applicant's Signature:

______________________________________________

Date: ____________________ DD/MM/YY

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