APPLICATION FORM FOR CHINESE GOVERNMENT SCHOLARSHIP

Personal Data:
Agency No.

Agency Name

10010

BEIJING UNIVERSITY OF CHEMICAL TECHNOLOGY

Family Name

Given Name

MAWANGA

MOSES

Chinese Name

Gender

Photo

Male
Date of Birth

Marital Status

1985-07-19

Single

Nationality

Native Language

Passport No.

Uganda

Other

B0830900

Country of Birth

City of Birth

Religion

Uganda

Kampala

Permanent Contact Tel

Permanent Contact Fax

Permanent Contact E-mail

+256-701-891333

mosesmawanga@gmail.com

Permanent Contact Address

Makerere University; College Of Natural Science, Department Of Chemistry P.O. Box 7062, Kampala, Uganda
Present Contact Tel

Present Contact Fax

Present Contact E-mail

+256-701-891333

mosesmawanga@gmail.com

Present Contact Address

Makerere University; College Of Natural Science, Department Of Chemistry P.O. Box 7062, Kampala, Uganda

Education Background and Employment Record:

Highest Diploma
Institution

Makerere University
Years Attended

Fields of Study

From 2006-08-05 To 2009-06-06

Industrial Chemistry

Certificates Obtained or to Obtain

BSc. Industrial Chemistry (Hons.)

Other Certificate I
Institution

Mbogo Mixed Secondary School

Years Attended

Fields of Study

From 2005-01-03 To 2005-12-20

Advanced Level (High School)

Certificates Obtained or to Obtain

Uganda Advanced Certificate of Education (UACE)

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Other Certificate II
Institution

Kibuli Secondary School

Years Attended

Fields of Study

From 1999-02-01 To 2004-12-21

Ordinary Level (College)

Certificates Obtained or to Obtain

Uganda Certificate of Education (UCE)

Current Employment
Employer

Baker Hughes - Uganda Operations

Time Engaged

Work Engaged

From 2012-04-23 To 2014-12-31

Rig site Mud operations

Posts Held

RDD Scientist I

Language Proficiency and Proposed Study in China:

Chinese Proficiency

Level of HSK test or other certificates

None
English Proficiency

I can be taught in English

Other Language

Good

yes

German

Apply for

Disciplines

Master's Degree

Engineering

Majors

Chemical Engineering and Technology

Preferences of Institution I

BEIJING UNIVERSITY OF CHEMICAL TECHNOLOGY

Preferences of Institution II

SOUTH CHINA UNIVERSITY OF TECHNOLOGY

Preferences of Institution III

ZHEJIANG SCI-TECH UNIVERSITY

Duration of the Major Study

From 2014-09-01 To 2015-07-15

Do You Need Elementary Chinese Study prior to the Major Study

no
Duration of Your Elementary Chinese Study (not included in the length of the major study)
Have you ever Studied or Worked in China

no
Institution or Employer

Time(from/to)

Contact in China and Family Members:

Guarantor's Name

Tel

E-mail

Fax

Address

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Spouse's Name

Age

Employment

Father's Name

Kamukamu Samuel (Late)

Age

Employment

Mother's Name

Tatu Nalwoga
Age

Employment

52

Business woman

Supporting Documentation Attached(Please Indicate with 'X' in the Bracket.):

Two Application Forms.
Two Letters of Recommendation.
Admission Letter or Admission Notice of Chinese Universities.
Transcripts of the Most Advanced Studies(Notarized Photocopy).
Diploma of the Most Advanced Studies(Notarized Photocopy):
Bachelor's Master's Doctor's Others
Foreigner Physical Examination Form(Photocopy).
Study Plan in China.
Articles or Papers Written or Published.
Examples of Art(6 color pictures)and Music(1 audio tape)Work(Only for the applicants applying for Fine Arts and Music).
Other Attachments(List Needed)_______________________________________________________________
Note:Each Set of the complete materials should not exceed 20 pagesPlease use DIN A4.
Whether the candidates are accepted or not,all the application materials will not be returned.

I Hereby Declare That:

1. All information and supporting documentation provided for this application are complete, true and correct.
2. During my stay in China,I shall abide by the laws and decrees of the Chinese government,and will not participate in any activities
in China which are deemed to be adverse to the social order of China and are inappropriate to the capacity as a student.
3. I will agree to the arrangements of my institution and specialty of study in China made by CSC,and will not apply for any changes
in these two fields without valid reasons.
4. During my study in China,I shall abide the rules and regulations of the host university,and concentrate on my studies and researches,
and follow the teaching programs arranged by the university.
5. I shall go through the procedures of the Annual Review of Chinese Govemment Scholarship Status as required.
6. I shall return to my home country as soon as l complete my scheduled program in China,and will not extend my stay without valid
reasons.
7. If I am judged by the Chinese laws and decrees and the rules and regulations of the university as having violated any of the above,
I will not lodge any appeal against the decision of CSC on suspending,or withdrawing my scholarship,or other penalties.

Signature of the Applicant:_____________________Date:_________

(The application is invalid without the applicant's signature)

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Serial Number: 299415

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