APPLICATION FORM

GLOBAL CONNECT SCHOLARSHIP PROGRAMME

THE REGENT’S SCHOOL - THAILAND
You are required to fill out all blanks (especially items #5 and #9).
1 Applicant’s Last Name
  First Name(s)
  Nick Name
  Email
2 Date of birth
  Place of birth
3 Gender
Nationality
4 Level of English Proficiency Very fluent Fluent Not fluent
5 Applicant’s Ranking in Math and English Class
(Please obtain your Principal’s confirmed statement that you have achieved what you wrote down in 5.1 and 5.2 below. Then please scan and email the written confirmation to chairman@regents.ac.th This application cannot be processed without your principal’s confirmation.)
5.1     In the Math class this year, my test result at present is ranked out of students.
5.2     In the English class, my test result at present is ranked out of students.
6 Musical/Dramatical talent: Very good Good Weak None
  Instrument  1)
                    2)
  Singing
  Drama
7 Athletic Ability Very good Good Weak None
  Sport           1)
                    2)
8 Service Activities Very active Active Not So None
  Specify        1)
                    2)
                    3)
9 Name of current School
  Country
  Principal’s name is
  Principal’s email address
10 how many brothers and sisters do you have?  
11 Parent's Particulars  
 
11.1 Full Name
11.2 Relation to the applicant  Father Mother Other
11.3 Name of his /her Employer
11.4 Please scan and attach a name card. If not available, please
  continue.   Address of Employer
11.5 Position and title
11.6  Employer pays for this tuition. No ; Yes all  all  xxx    part xxx
11.7 Tel of parents
  Fax
  E-mail
11.8 mailing address
12 What are your particular strengths and interests that could benefit other people
 
13 Do you have or had – any physical or emotional problems or need of medical treatment? ( Failure to disclose this medical information will disqualify the award.)  
 
14 What is important in your life, now and in the future?
 

The Regent’s School – Thailand
Bangkok:  
592 Pracha-Uthit Road    
Huay Kwang, Bangkok 10310
Tel: 662-690-3777 
Fax: 662-690-3778
  		Pattaya:          
P.O. Box 33, Naklua
Banglamung, Chonburi 20150
Tel: 66-38-734-777
Fax: 66-38-734-778
E-mail: enquiry@regents.ac.th   Website:  www.regents.ac.th