Institute of International Education

GE Foundation Scholar Leaders Program

Deadline: Applications must be send to IIEF by February 28, 2014 (post mark)

Certification for ____________________________________ [insert printed name of applicant]

Application ID#: ID- ________________

By my signature below, I certify that I meet the basic eligibility requirements of the program and that the information provided is complete and accurate to
the best of my knowledge. If requested, I agree to give proof of the information that I have given in my application. Falsification of information may result
in termination of any scholarship granted. This application becomes the property of the Institute of International Education (IIE) and the Indonesian
International Education Foundation (IIEF) upon submission. I also agree that, if selected as a GE Foundation Scholar-Leader, IIE/IIEF, GE and the GE
Foundation may use my name, likeness and biographical information in promotion of the GE Foundation Scholar-Leaders Program, in any media
whatsoever.




Signature of Applicant Date
Additional Documents
Thank you for completing an application for the GE Foundation Scholar-Leaders Program in Indonesia. You are almost finished! In addition to the
completed application, you are required to provide originals (where possible) or clear, certified photocopies of the documents listed below.

For your application package to be considered complete, please ensure that you send the items below:

Completed application form signed and dated
One (1) color photograph 4 x 6 cm affix it in the provided box
One (1) copy of valid Identification Card (KTP)
Original official letter of enrollment from university
One (1) certified copy (legalisir) of your university transcript records from semester 1 to 3
One (1) copy of high school diploma (Ijazah SMU)
One (1) copy of high school transcript record (STTB)
One (1) copy of high school transcript record national standard (NEM)
At least two (2) Letter of Reference from Academic Supervisor and other Faculty Member (submitted electronically by your recommenders in
the online system), preferably from your English teacher at the university.
One (1) letter of salary amount information of your parents for the last month (slip gaji)
One (1) copy of family card (KK-Kartu Keluarga)
Original letter of notification from campus or institution that you are involved in sosial and student activities (surat keterangan aktif di organisasi
kemahasiswaan atau sosial lainnya yang asli dicap dan ditandatangan oleh kampus atau institusi)

Your complete application package must be sent by February 28, 2014 (post mark), in order to be considered. Late or incomplete applications
cannot be considered.

Send to:
GE Foundation Schol ar-Leaders Program I I EF
Menara Imperium 28
th
Floor Suite B
Jl. HR Rasuna Said
Jakarta 12980, INDONESIA
All submissions become the property of the Institute of International Education. All data will be available only to members of the
Institute of International Education and the selection panel. Financial information provided through this application will only be
used for competition purposes and will be treated with the utmost confidentiality. Biographical information may be used in
promotion of the program.
EDO RONALDO
EDO RONALDO