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Scholarship Certificate

On behalf of:

Undersigned declares hereby that:

will receive during the period:

a monthly scholarship of:

The scholarship is funded by:

Name Scholarship programme:

Name scholarship organisation:

Town/city and country:

Surname student:

Given names student: Date of birth:

Nationality:

Starting date (dd/mm/yyyy): / / End date (dd/mm/yyyy): / /

Date: Town/city:

Name: Signature:

Name institute or company:

Stamp organisation:

Name Institute or Company funding the student:

Address:

Postal code + city:

Telephone number:

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