Culture, Health, Education, Environment, Resources Plant a Seed of Peace A Foundation for Children and Education in Viet Nam P.O. Box 341 . Culver City, California 90232 . www.cheerforvietnam.org

CHEER for Viet Nam Scholarship Award for Innovation and Creativity 2017-2018 Application Form Please submit the Application form along with two Letters of Recommendation from the Dean, your immediate advisor and/or professor of your appropriate school, and all required materials. Thank you for your interest in CHEER for Viet Nam Scholarship Award for Innovation and Creativity.

1. Applicant’s Name: ____________________________________________________ 2. Date of Birth: ________________________________________________________

3. Place of Birth: District ________________________Province _________________ 4. Current Address: _____________________________________________________ 5. Email: _____________________________________________________________ 6. Mobil: _____________________________________________________________ 7. Field of Study _______________________________________________________ 8. Year in School _______________________________________________________ 9. Grade Point Average: __________________________________________________ 10. Father’s Name and Occupation: __________________________________________ 11. Mother’s Name and Occupation: __________________________________________ 12. Applicant’s Statement -The reasons for your application to this scholarship and its contribution to your study and community. 15. Applicant's Project Description -Name of Project -Purpose -Description of Project -Desired results at completion of Project -Length of Project -Itemized Budget The deadline for the Application is November 15th, 2017.

For more information please contact University of Social Sciences and Humanities: Name of contact person/Title Email, telephone