Ideas Scholarship Application Form

A joint program from
MIT Sloan School of Management | United in Diversity Forum

IDEAS‐Indonesia Fellowships, 2008‐2009
Scholarship Application Form

IDEAS-Indonesia is an innovative program conducted in two phases. In phase one, IDEAS-Indonesia is presented by the Massachusetts Institute of Technology (MIT) Sloan School of Management in the USA. In phase two, IDEAS-Indonesia is presented by MIT Senior Lecturers and ELIAS Fellows. IDEAS-Indonesia is an integrated program: leading MIT and ELIAS Fellows who create and conduct IDEAS-Indonesia insure the integrated presentation of the experiential learning journey and develop competence to learn from the future, as it emerges.

SCHOLARSHIP APPLICATION

Please answer all questions. Application must be fully completed in English. Please submit scholarship application form to scholarship@unitedindiversity.org. All relevant information must be received by 15 July 2008.

GENERAL INFORMATION :

NAME: *

NICKNAME OR PREFERRED NAME:             MALE             FEMALE

DATE OF BIRTH:     / / *
Day/Month/Year

ADDRESS:

TELEPHONE (Mobile):                 TELEPHONE (Landline):

E-MAIL:   *

TITLE OR POSITION:                  DIVISION/DEPARTMENT (if applicable):

ORGANIZATION:

QUESTIONS: (Please attach any additional sheets, as needed, with your name on them.)

1. Briefly describe the leadership journey that brought you to your current position.

*

2. What challenges do you currently face that needs new and innovative approach?

*

3. What leadership capabilities would it take to address these challenges – who are the key players who need to work together?

*

SCHOLARSHIPS GUIDELINES

MIT Sloan School of Management and United in Diversity will award limited number of scholarships, based on the availability of institutional and private funds, to well deserved applicants. Each scholarship is for US$30,000 to cover the tuition fee for the entire Program.

      I.        ELIGIBILITY REQUIREMENTS

                Recipients of the scholarship are required to:
                A. Complete the Application Form.
                B. Complete the Scholarship Form
                C. Sent personal CV.
                D. Submit a Letter of Recommendation from your organization or supervisor to support your application

      II.        APPLICATION PROCEDURES

                 Complete and submit to scholarship@unitedindiversity.org

      III.        SELECTION OF RECIPIENTS

                  Selections will be based on the applicant's overall relevance of current work relative to IDEAS-Indonesia objectives, level of influence in
                  current organization, experience in working with multi-stakeholders and availability of time to attend the Program

      IV.        NOTICE OF AWARDS

                  Students will be notified by mail of any scholarship award or denial.

                  Should your scholarship application is not awarded for this batch; would you be interested to renew your scholarship application for the
                  next batch of IDEAS-Indonesia program?

                                                                   Yes                          No