Capernaum Scholarship Primary & Secondary Application Form

Please fill in the below form to apply for the Higherlife Foundation Capernaum Scholarship. The information included on this form will be kept strictly confidential and this is necessary to ensure that the Foundations limited resources are allocated as fairly and justly as possible. On submission of this form, you will receive an application confirmation email. The Scholarship Committee will then review and consider all applications and you will be contacted upon being successful.





Personal Details

Date Of Birth:
Gender:
Please indicate your vulnerability status by selecting the appropriate option (SM, SF, DO, PC, VC, I/O):

Sibling Details

Parent/Guardian Details

Employment Status Of Parent(s)/Guardian
Mother (Paid Employment): Father (Paid Employment):
Employer Of Surviving Parent/Guardian

Household Details

Ownership Of Household:

School Details

Educational Background

Which level are you currently enrolled for (Grade/Form)? What is your enrolment status?

Grade Seven ZIMSEC Level Exam Results

‘O’ Level Exam Results

Spiritual Background

Are You Born Again?
When Were You Born Again?
Do You Attend Cell Group Meetings?

Funding

Are You Currently Receiving Funding From Any Another Organization(s)?

Other Information

Attach these documents below (Please note that the documents must not exceed 225KB):

  • Certified copy of Birth Certificate
  • Certified copy of Death Certificate(s) of biological parents in case of orphan hood or affidavit/s
  • Certified copies of ‘O’ and ‘A’ level Certificates
  • Original invoices with bank details i.e. Name of bank, account number and branch
  • 1 Passport sized photograph
  • Certified copy of National ID
I do hereby confirm that the information I have provided above is TRUE, bearing in mind that if it is found to be otherwise, my application will be disqualified