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Scholarship Form
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​Training/Scholarship Application Form​
Type Of Application
*
Please select a value...
Local full time scholarship
International full time scholarship
KAAUH Employee
*
Yes
No
KAAUH ID No
​
Date Of Hire
Department
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​
​​​Personal Information​
Name Of Specialty Your Applying For
​*
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Applicant Full Name
*
الاسم الرباعي باللغة العربية
*
Job Title
*
Extension Number
Address
*
Home Phone Number
Mobile Number
*
Personal Email
*
Work Email
Saudi ID Number
*
Gender
*
Please select a value...
Male
Female
Passport Number
*
Place Of Birth
*
Date Of Birth
*
Marital Status
*
Please select a value...
Single
Married
Divorced
Widowed
Number Of Children
​
Please select a value...
Not Applicable
0
1
2
3
4
5
Specify your own value:
​
​​​Legal Guardian (Mahram) or Spouse Information​
Guardian/Spouse Name
*
الاسم الرباعي باللغة العربية
*
Saudi ID Number
*
Relationship
*
Contact Number
*
​
​​​Dependents (Children) Information​
(if applicable)
Dependent Name
Age
Gender
Male
Female
Male
Female
Add another dependent
​​​Academic Performance​
(kindly start with the highest degree received)
​
Certification
Date Obtained
School/Institute
Grade/Average
Add another certification
​​​Employment History​
(kindly start with the most recent employment)
Organization Name
Date From
Date To
Position Title
Add another history
​​​Application Details
Program Title
*
Degree to be obtained upon completion
*
Please select a value...
Bachelor's Degree
Master's Degree
PhD
Residency
Fellowship
Certificate
N/A
Specify your own value:
Training Institute Name
*
Location - City
*
Location - Country
*
Program Duration
*
​
Received Acceptance
*
Yes
No
Program Starting Date
Is your acceptance conditioned?
​
Yes
No
Acceptance Condition
​
​
Is there a similar program locally?
Yes
No
Similar Program - Where?
Have you been previously awarded or benefitted of a scholarship grant?
*
Yes
No
When?
​
Where?
Updated CV​​
*
Add Attachment
Select a file
Name
The maximum file size allowed is: 10240 MB
Academic Transcript Of Records​
*
Add Attachment
Select a file
Name
The maximum file size allowed is: 10240 MB
Acceptance Letter​
*
Add Attachment
Select a file
Name
The maximum file size allowed is: 10240 MB
Any Certificates Of Qualification​
*
Add Attachment
Select a file
Name
The maximum file size allowed is: 10240 MB
Recommendation Letters (2)​
*
Add Attachment
Select a file
Name
The maximum file size allowed is: 10240 MB
Personal Statement​
*
Add Attachment
Select a file
Name
The maximum file size allowed is: 10240 MB
Passport Size Photo​
*
Add Attachment
Select a file
Name
The maximum file size allowed is: 10240 MB
Other Attachment​s
Add Attachment
Select a file
Name
The maximum file size allowed is: 10240 MB
Statement Of Understanding:
I attest that theinformation provided in this form is true and accurate, and that anymisrepresentation I make will be sufficient grounds for my disqualification or terminationfrom King Abdullah bin Abdulaziz University Hospital Training/ScholarshipProgram.​
Agree
Do you think there is a need for this degree for the development of KAAUH Services?
Yes
No
Have you reviewed and support the caliber of the requested program?
Yes
No
Do you recommend this applicant for KAAUH Training and Scholarship Program?
Yes
No
Department Executive Comments
Use this page to add attachments to an item.
Name
​​