Scholarship Application – Lord Kitchener National Memorial Fund

Applicant's Details

Please complete the following information with your details.

Email address*

Ethnicity*

Have you served in HM Armed Forces?*

Yes
No

Full details of applicant's own service*

Parent/ Guardian's Details

Please complete the following information with your parent/ guardian's details.

Are either of your parents deceased?*

Yes
No

Details of deceased parent(s)*

Mother or father	Date of death (dd/mm/yy)	Place of death

Parent's Service in HM Armed Forces (Parent 1)

Particulars of parent's service in HM Armed Forces, giving name, service number, rank, decorations, and date of commencement of service and of retirement. For candidates with an Army background, please state Regiment or Corps.

Full name*

Details of any decorations

Have both your parents served in HM Armed Forces?*

Yes
No

Parent's Service in HM Armed Forces (Parent 2)

Particulars of other parent's service in HM Armed Forces, giving name, service number, rank, decorations, and date of commencement of service and of retirement. For candidates with an Army background, please state Regiment or Corps.

Full name*

Details of any decorations

Educational Details

Please complete the following details regarding your educational history, achievements and qualifications

Are you, or have you been, a candidate for any award from any of the sources mentioned below? If so, name the source and result of your application

College or University Scholarship
Local Education Authority grant
Industrial or Services grant
Other grants, including, Trust Funds, Private Income, School Scholarships

Regarding your award, please name the source and result of your application*

Secondary Education

Please complete the following details for the school where you completed your secondary education

School name*

Name of Headmaster/ Principal*

First Last

University

Please complete the following details regarding your proposed plans for university

Which type of university offer(s) have you received?*

Unconditional place
Conditional place

Select all that apply.

Unconditional offer details*

At which university(s) have you been offered an unconditional place?	In what year do you hope to obtain your degree?

At which university(s) have you been offered an unconditional place?

Conditional offer details*

At which university(s) have you been offered a conditional place?	In what year do you hope to obtain your degree?

At which university(s) have you been offered a conditional place?

Examination Results

In what subjects have you passed in the following or comparable examinations?

Which of the following qualifications do you have?*

GCSE or equivalent
AS Level or equivalent
International Baccalaureate
Pre-university/ other subject

GCSE or equivalent subject	Grade	Date

Please complete details of all your GCSEs or equivalent qualifications

AS Level or equivalent subject	Grade	Date

Please complete details of all your AS Level or equivalent qualifications

IB subject	Grade	Date

Please complete details of all your International Baccalaureate qualifications

Pre-university/ other subject	Grade	Date

Please complete details of all your pre-university/ other subject qualifications

Advanced or Scholarship Level Qualifications

Offered by applicant in the summer of this academic year

A Level or Scholarship Level	Subject	Grade (state if predicted or actual)

Career prospects and Interests

What are you considering as a future career?*

What are your chief interests and activities and what positions of responsibility have you held?*

Have you carried out any employment?*

Yes
No

What employment(s) have you carried out?*

Interviews and Final Comments

Interviews take place in London in July, August and September. If you intend to study in Scotland you should consider a July interview as Scottish universities tend to start early in September.

Would you prefer a July appointment?*

Yes
No

Note: Every candidate must let the Secretary know by email his or her A-Level (or equivalent) results immediately they are published, if possible with confirmation of university location, subject and duration of degree course.

Additional Comments

This box may be used by applicants for making any special statement in support of this application.

Data Protection Privacy Notice

The Lord Kitchener National Memorial Fund (LKNMF) need to collect data to allow the processing of your application for a Scholarship. Should your application for a Scholarship be unsuccessful, the data you provided will be destroyed. If you are successful and awarded a Scholarship, your data will be held and used by the LKNMF and the Kitchener Scholars’ Association (KSA) Alumni. Your contact details will not be shared, sold or otherwise disposed of to any organization other than those stated. You will only be contacted by the LKNMF and KSA for matters relating to the business of your Scholarship and membership of the Alumni, including fundraising for the same. We only require your bank details to process your travel expenses and Scholarship payments. After this, the financial information you have provided will be destroyed. Your contact information will be held securely by the Secretary of the LKNMF and KSA and you will be able to withdraw your agreement to be contacted at any time and ask for the information we hold to be destroyed. At the bottom of your Scholarship application you are to indicate on the application your agreement to the LKNMF and KSA to hold the data as outlined in this privacy notice.

Name

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