BETTING, GAMING AND LOTTERIES COMMISSION

SCHOLARSHIP APPLICATION FORM

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SECTION A – APPLICANT INFORMATION
1. Name of Applicant
_____________________________________________________________________________
Surname Christian Middle I
2. Address______________________________________________________________________
______________________________________________________________________________

3. Telephone & Email ________________/_________________________/_________________

Home Mobile Email
4. Date of Birth ___________/_________/___________________________________________
Month Day Year
5. TRN:_______________________________

SECTION B – DETAILS OF PROGRAMME

Name of Institution ____________________________________________________________

1. Level of Study: Undergraduate Postgraduate

2. Programme Title: ________________________________ Duration:_____________________
3. Mode of Study: Part-time [ ] Full-time [ ] On Line [ ] Other [ ]
4. Current Status : Letter of Acceptance [ ] 1st [ ] 2nd [ ] 3rd [ ] 4th [ ] N/A [ ]
5. Programme Cost: Tuition Annual____________________ Other_____________________
6. Have you previously been awarded a scholarship/grant from, the BGLC Fund and or
any other Government of Jamaica source for any course of study, if yes, please provide
details:
______________________________________________________________________________
______________________________________________________________________________
7. If student loan :
 Amount borrowed __________________________
 Repayment arrangement _____________________
 Status __________________________
 If currently enrolled in an institution, how do you presently support your expenses?
Student Loan [ ] Bursary [ ] Parental Support [ ] Self-financed [ ]

Other (please state __________________________________________________________

SECTION C – EDUCATION

1. Please give details of your academic qualifications and attach transcripts giving subject
details and results.

Institution Course Level of Duration of Study

Qualification
Obtained

2. List your major achievements related to the programme of study (Award received,
positions held, events in which you have participated, etc.)
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

SECTION D – REFERENCES

1. List the names of TWO confidential references including one from the Dean of Studies,
Community Organization or Church and one from the following:
a. Principal/Lecturer (Lecturer for Teachers already studying)
b. Chairperson/Corresponding Sponsor of School Board
c. Teacher

Name :______________________________ Name_________________________________

Position:____________________________ Position:______________________________

Address:____________________________ Address:______________________________

Tel.:________________________________ Tel.:__________________________________
SECTION E – PERSONAL STATEMENT

1. On a separate attachment, in no more than 200 words, write your reasons for applying
for the programme and the benefits you hope to gain from successful training.

I ___________________________________________________________ hereby certify that the

information given is accurate to the best of my knowledge. I am aware that I will be bonded for
a period as specified by the Ministry of Finance (MOF).

____________________________________ _____________________________
Applicant’s Signature Date

Application Checklist

In order to expedite your application, please ensure the following checklist is complete prior to
the submission of your application

1. One (1) passport size photographs

2. Acceptance letter (if applicable)
3. Sealed recommendations of good standing
4. Transcript (where applicable)
5. Statement of Accounts/invoice from school
6. Attached essay for Section E
 OFFICIAL USE ONLY

Application accepted : Yes [ ] No [ ]

Date Received: _________________________________

Scholarship Recommended: Yes [ ] No [ ]

Scholarship Awarded: Yes [ ] Period: ___________________

Amount Awarded _____________________

Interview Assessment:

___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________

Signatures ______________________________ __________________________

Date

_____________________________ ___________________________
Date
 RECOMMENDATION FORM

One recommendation is required for scholarship consideration, additional recommendations are

optional. Your recommendation(s) should come from individuals who can speak to your personal
character and potential for academic success. Feedback from a teacher or school-based official is
preferred.

1. To be completed by the APPLICANT

_____________________________________________________ __________________
Full Legal name as it appears on Application for Admission Date of Birth

_____________________________________________________ __________________
Applicant Signature Date

2. To be completed by the RECOMMENDER

You may submit this Recommendation Form OR a letter of recommendation OR both.
Check the box that best describes this applicant:

No Basis Quantities Below Average Above Outstanding

Average Average (top 5%)
Academic motivation
Academic potential
Academic achievement
Creative/original thought
Initiative/Leadership
Character/Integrity
Interpersonal Skills

I recommend this student: With reservation Fairly Strongly Strongly Enthusiastically

Comments (Optional)

Please feel free to include here (or attach an additional sheet) any information not reflected elsewhere in the
application or transcript that you think will assist us in evaluating this student’s potential for success.

Name of Recommender:________________________ Signature: _____________ Date:____________

What is your relationship to/connection with this applicant? Please include details such as your title and institution
name (if school official) and the length of time and capacity in which you have worked with/taught the applicant.
_____________________________________________________________________________________________
___________________________________________________________________________

Phone: __________________________ Email:___________________________________________

Submit this form to The BGLC Education Fund, Betting, Gaming and Lotteries Commission, 78cef
Hagley Park Road, Kingston 10. Please see the press or the BGLC website for deadline for submission:
www.bglc.gov.jm or email: info@bglc.gov.jm for further information.