Miami Ad School - Registration for Feb. 2012 Scholarship Competition

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1. Surname

Surname

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2. First Name

First Name

3. Middle Name

Middle Name

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4. Date of Birth

	DD		MM		YYYY
Date of Birth	Date of Birth   Date of Birth   Day	/	Month	/	Year

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5. Gender

Gender   Male

Female

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6. Contact Information

Contact Information   Address Line 1:
Address Line 2:
City/Town:
State:
Country:
Email Address:
Phone Number:

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7. Schools Attended, Qualifications and Year Obtained (minimum of Ordinary National Diploma (OND)or equivalent)Example: University of Lagos, B.Sc. Sociology, 2008.

Schools Attended, Qualifications and Year Obtained (minimum of Ordinary National Diploma (OND)or equivalent)Example: University of Lagos, B.Sc. Sociology, 2008.   1.
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8. Current and Previous Employment, Starting With the Most Recent

Current and Previous Employment, Starting With the Most Recent   1.
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4.
5.

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9. If you win a scholarship to Miami Ad School it will only cover full tuition or half tuition. Will you be able to provide enough resources of your own to cover flight ticket to your desired campus and cover living expenses?

If you win a scholarship to Miami Ad School it will only cover full tuition or half tuition. Will you be able to provide enough resources of your own to cover flight ticket to your desired campus and cover living expenses?   Yes

No

Maybe

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10. I agree that the judges decision in the competition will be final.

I agree that the judges decision in the competition will be final.   Yes