THE MULJIBHAI MADHVANI FOUNDATION
Guidelines
THE2015/2016
MULJIBHAI MADHVANI
FOUNDATION
and
Application
form
2015/2016 Guidelines
and Application form
www.madhvanifoundation.com
1.0 BACKGROUND
The Muljibhai Madhvani Foundation is a Charitable Trust which was
set up with the primary objective of promoting scientific and technical
education for the betterment of the people of Uganda.
It is in pursuit of this objective that the Board of Trustees of the
Foundation set up a Scholarship Committee and instituted a University
scholarship programme starting in the 2003/4 academic year.
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The financial status of the applicants themselves, their parents,
families and/or spouses shall be scrutinized to assess their relative
financial needs.
The Board of Trustees has empowered the Scholarship Committee
to use their discretion in considering the Applicants and identifying
those suitable for sponsorship. The Committee may use additional
parameters, such as gender, regional balance and disability, where
candidates are equally qualified.
Postgraduate Applicants with work experience in the relevant field of
study will have advantage in award of Scholarship.
The Foundation reserves the right to check and verify any information
provided by the applicant.
The Foundation reserves the right to reject any application.
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Any form of canvassing will lead to immediate disqualification.
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The scholarship programme is aimed at benefiting Ugandans pursuing
either undergraduate or postgraduate education at University level in
Uganda.
2.0 ELIGIBLE DISCIPLINES
The Board of Trustees have identified the following disciplines for
sponsorships: Agriculture, Biology, Chemistry, Commerce, Engineering, Food Science
& Technology, Information Technology, Hotel Management, Pharmacy,
Nursing, Architecture, Veterinary Medicine, Actuarial Science,
Environmental Studies and Human Medicine.
The Board however, reserves the right to revise this list periodically, on
the recommendation of the Scholarship Committee, to suit the relative
importance of each of the disciplines in the wider strategic framework of
national capacity building.
3.0 WHO IS ELIGIBLE TO APPLY?
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Undergraduate students (Ugandan Nationals), who have completed at
least the first year of their studies at a Ugandan University; (in any of
the disciplines in 2.0 above), are eligible to apply. Students with CGPA
lower than 2.2 and/or having a retake in any subject in the
first/preceding year of study are not eligible to apply.
Postgraduate students (Ugandan Nationals), who have either been
admitted and/or registered for postgraduate programmes at a
Ugandan University. (A first degree in the disciplines in 2.0 a must).
Students already on scholarships or sponsorships with other
organizations are not eligible to apply.
Also, the successful applicants who may be awarded scholarships
or sponsorships by other organizations after the Muljibhai Madhvani
Foundation scholarship award shall be discontinued.
5.0 WHAT DOES THE SCHOLARSHIP COVER?
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application/award.
6.0 NATURE OF SCHOLARSHIP
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Undergraduate applicants; proof of completion of the first year of
study in a recognized university in Uganda. The
higher one’s CGPA, the better.
Postgraduate applicants; proof of admission to a postgraduate
programme in a recognized University or Institution of Higher
Learning in Uganda.
Academic performance; the applicants’ Cumulative Grade Point
Average (CGPA) and/or class of degree as well as academic
references shall be among the variables to be used in determining
successful applicants.
The applicant’s age and character shall be considered.
The scholarship shall be extended as a grant payable directly to the
University/Institution on behalf of the beneficiaries.
Renewal of funding shall be subject to receiving satisfactory progress
reports from the beneficiaries’ Faculties/ Institutes/Schools/Colleges,
either submitted directly or by the beneficiaries.
Retakes in more than one subject will result in the withdrawal of the
Scholarship by the Trust.
Upon completion of their studies, it is expected that the awardees
will, for the benefit of future scholars, make voluntary donations/
contributions to the Foundation.
It may also be noted that the award of Scholarship is not a legally
binding contract between the Foundation/ Trustees and the Awardees
and can not be challenged in any court of law.
The Foundation/Trustees also reserve the right to withdraw the
scholarship or stop payment of the tuition fees at any time at its own
discretion without assigning any reason to the awardees.
7.0 APPLICATIONS
4.0 SELECTION CRITERIA
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The scholarship covers tuition fees only from the second year
to completion for undergraduate students; and for the entire
programme of study for Postgraduate students from the time of
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The Application form can be bought for 2,000 Ushs at the Madhvani
Foundation offices on Plot No.96-98, Business Park, 5th Street,
Industrial Area or downloaded for free from the Foundation website
www.madhvanifoundation.com.
All sections of the application form must be carefully filled in,
attached with relevant documentation and submitted along with a
signed Model Release Form. Section F must be filled by the relevant
officer and stamped.
The Completed application form can either be delivered in person
or posted to Muljibhai Madhvani Foundation, P. O. Box 33479, Plot
No.96-98, Business Park 5th Street, Industrial Area, Kampala,
Uganda
Applicants, whose forms are not filled properly as required or
Section E has not been filled in or have failed to attach the relevant
supporting documents shall be rejected.
LAST DATE FOR SUBMISSION OF APPLICATION IS 30th APRIL 2015
NOTE: PLEASE RETAIN THE GUIDE AND SUBMIT ONLY THE APPLICATION FORM
APPLICATION FORM FOR
SCHOLARSHIP AWARD 2015-2016
• First fill the Table below, and then carefully read through the rest
of the form before filling in Sections A – G as candidly as possible.
• You are advised to attach relevant photocopies to this form in
support of all verifiable statements.
• Incomplete information will lead to rejection of the application.
• Applicants with CGPA lower than 2.2 are not eligible to apply.
• LAST DATE FOR SUBMISSION OF COMPLETED APPLICATION FORM
IS 30TH APRIL 2015
Name of Applicant
Title of Program
(e.g Bachelor of Medicine)
Year and Semester / Term of study
(as on 30th April 2015)
CGPA –Cumulative Grade Point Average
(Attach an original signed and stamped statement of results as proof)
University being attended / admitted
Admission Number
Name of sponsor
Details of previous application made for Scholarship to
the Madhvani Foundation - Year
PLEASE PASTE
RECENT PHOTOGRAPH
DO NOT STAPLE
SECTION A
Applicant’s Particulars
1. a) Surname
b) First name
c) Middle name (if any)
2. a) Sex:
Male:
Female
b) Nationality:
3. a) Date of birth
b) Age ( In years as on 30/04/2015).
4. a) Marital status
b) Number of children / Ages
5. a) District of origin
b) County
c) Sub-County/Division
d) Parish/Ward
e) LC1/Village
6. a) District of Residence
b) Postal address
c) Physical address
d) Phone contacts:
i) Residence
ii) Mobile
e) If no. in 6 d) ii) above is not yours, indicate the owner’s name
f) E-mail address
For items 7 – 9 below, please indicate employment details about you (and your spouse where applicable).
Details
7
Employer and contact
8
Occupation / Job title
9
Gross annual income
Self
Spouse
SECTION B
Family Background
For items 10 – 15 in the table below, please indicate the details about your parents.
Particular
10
Name
11
Status (Alive / Deceased) If deceased, give date of death with proof
12
District of origin
13
Occupation/ Job Title Either now or previously
14
Organization / Place of Work / Phone contact
15
Gross Annual Income
16
a)
If deceased in No.11 (above), state name of guardian
b)
His/her phone contact
c)
His/her Relationship with you
d)
Guardian’s occupation
e)
Guardian’s Gross Annual Income
Father
1
Mother
17. Give details about your brothers/sisters from the same father/mother who are either ‘out of’ or ‘still in’ school in the table
below. Attach an additional sheet if more than 4.
Name
Occupation / Year
in school / College /
University
Name of Organization
/ School / College /
University
Name of
sponsor
SECTION C
Applicant’s Education and Funding Levels
18. Please summarize the educational stages you went through (before applying to join the University for the current program) in
the table below. Please attach a hand written summary on the history of your sponsorship i.e. how was your fees paid
and who paid it from PLE onwards.
Name of School / College /
University attended
Level
Dates
from - to
Aggregate / Grade /
CGPA / Class
Name of Sponsor
/ Relationship
PLE
UCE
UACE
Diploma
Bachlor’s
Degree
Postgraduate
Diploma
Master’s
Degree
19. State the Cumulative Grade Point Average (CGPA) mark obtained in the latest University examination available at your Faculty
office ............................................................................................................. [Please attach an original statement of results
from the office of the Dean/ Director of your Faculty/ School/Institute/college (duly signed and stamped) in support of this].
20. Funding applied for:
Item
Amount
Tuition fees per Semester / Quarter
Total tuition fees required to complete the degree programme
Course duration in years
2
21. Briefly outline your intended career path
SECTION D
Applicant’s Work Experience Details (FOR POSTGRADUATE STUDENTS ONLY)
22. Please summarize the details of work experience gained after successful completion of the undergraduate degree course in
the table below. Please note that experience in the field of undergraduate study would be an added advantage for award of
scholarship
Sr. No.
Name and address of Organization
worked for with Job Title
Dates from - to
Total Emoluments
SECTION E
To be filled in by all Applicants
Declaration: I hereby confirm and certify that the information I have filled in this form is correct.
Name
Signature
Date
3
Reason for leaving
Employment
SECTION F:
To be filled by the Dean / Director of the School / Faculty / Institute / College
23. Please comment on the applicant’s suitability for a scholarship award:
a) Academic Performance (please state the applicant’s current CGPA)
b) Behaviour
c) Comment on sponsorship history of the applicant
Recommendation
Dean/Director’s name in full:
Signature
Date
Faculty /College Stamp/Seal
Note: Please enclose the following:
V. Recent colour photograph (to be pasted in the space provided on page 1)
VI. Employers Certificate/No objection letter (If applicable)
VII. Copies of any other relevant documents
VIII. The signed Model Release Form here attached.
I. Photocopy of admission letter
II. Photocopies of examination results obtained: O & A Level, diploma,
transcript/results for all semesters done at university
III. Photocopy of death certificate or medical forms as proof of death or
illness
IV. Two original letters of reference outlining your financial situation and
need. One of which should be from the institution in which you are
studying and the other one from the immediate past institution where
you completed your studies.
Please address your application to:
THE SECRETARY, MULJIBHAI MADHVANI FOUNDATION
C/o. EAST AFRICAN DISTRIBUTORS LIMITED
PLOT NO. 96-98, BUSINESS PARK, 5TH STREET, INDUSTRIAL AREA
P.O. BOX 33479 KAMPALA, UGANDA, TEL: 0414 259 390 MOB: .0773 215 554
PLEASE NOTE THAT ANY FORM OF CANVASSING AND THE ABSENCE OF ANY OF
THE ABOVE REQUIRED ENCLOSURES WILL LEAD TO THE APPLICATION BEING REJECTED
It may also be noted that the award of Scholarship is not a legally binding contract between the Foundation/ Trustees and the Awardees and
can not be challenged in any court of law. The Foundation/Trustees also reserve the right to withdraw the scholarship or stop payment of the
tuition fees at any time at its own discretion without assigning any reason to the awardees.
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SECTION G:
MODEL REALEASE FORM
If selected to be awarded a scholarship, I agree to model for Muljibhai Madhvani Foundation/Madhvani Group for any public relations purposes
and/or commercial photography for the purpose of promoting their services at no cost. I permit Madhvani Group and its associate Companies/
assignees/suppliers to use the said material either complete or in part, alone or in conjunction with any wordings, caption or drawing. Muljibhai
Madhvani Foundation/Madhvani Group/their Associate Companies can use these photographs for purposes of out-door advertising or any other
media or before any forum gathering for the promotion of its client’s services.
PRESENTATION
I also agree that any person authorised or acting on behalf of Muljibhai Madhvani Foundation/Madhvani Group/their Associate Companies
may use the said materials or reproductions or adoptions of them for advertising with reasonable retouching alterations or editing. Muljibhai
Madhvani Foundation/Madhvani Group/Their Associate Companies and its assignees/suppliers/client shall have unrestricted use of the said
materials for a period of five years.
EXCLUSIVITY
I also agree that I will not model for any other competing organisation or firm for which any of the said material is used and/or contradicting any
advertisements that Muljibhai Madhvani Foundation/Madhvani Group/their Associate Companies or its Client may have published. I also agree
and promise that I will not prosecute or institute any proceeding or make claims or demands either against Muljibhai Madhvani Foundation/
Madhvani Group/their Associate Companies or its assignees/ supplier/client, or in respect of any uses by Muljibhai Madhvani Foundation/
Madhvani Group/their Associate Companies or them of the said material whether or not my name is used or not with such material.
I have been explained and have clearly understood the details of this Release Form.
Signed:
APPLICANT
Name
P.O. Box
Telephone
Email:
Signature
Date
Muljibhai Madhvani Foundation
C/o East African Distributors Limited, Plot No.96-98, Business Park,
5th Street, Industrial Area, P.O. Box 33479, Kampala, Uganda,
Tel.0414 259 390, Mob: 0773 215 554,
Email: admin@madhvanifoundation.com
www.madhvanifoundation.com