Application Form
for Sutaruk Scholarship 2021-2022
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Email *
You are from: *
First name *
Last name *
Year of birth *
MM
/
DD
/
YYYY
Home address *
Your cell phone *
Years you have lived in Dubno, Netishyn or Slavuta *
Name of the school you are finishing this year: *
Names of the University/Institute  you are planning to enter this year (it may be a several options): *
For what faculty and major study (спеціальність) are you applying? *
Please list all the classes you had the previous semester (chvert’) and grades you received in these classes: *
12
11
10
9
8
Less than 8
1. Ukrainian language
2. Ukrainian literature
3. Algebra
4. Geometry
5. History of Ukraine
6. World History
7. English
8. Physics
9. Chemistry
10. Biology
In what school subjects are you most interested? Please, indicate few options. *
Did you participate in school competition in these subjects (olimpiada)? If yes, name the level of the competition (shkilna, rayonna, oblasna, vseukrains’ka olimpiada) and your result in the latest year of participation. *
In what other academic contests, competitions, conferences, research, etc., have you participated? *
Did you earn any special achievements, honors and recognition? If yes, please list them. If no - just answer "No". *
If you could draw / paint a picture, what or who would be the subject of your picture?  Why?  Where would you display it?  Please tell us a little about your picture. *
How has living during the pandemic affected you? *
A copy of your responses will be emailed to the address you provided.
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