AMCHAM-MACEE SCHOLARSHIP 2011

The American Malaysian Chamber of Commerce (AMCHAM) and the

Malaysian-American Commission on Educational Exchange (MACEE)
are pleased to announce the competition for the 2011AMCHAM-MACEE Scholarship.

This scholarship is open to qualified Malaysian students who have been accepted to an accredited
American college or university for the Fall of 2011, in the United States for four years of study culminating
in a Bachelors degree. The scholarship application deadline is May 30, 2011 at 4:30pm.

AMCHAM supports member business interests and Malaysian economic growth through
proactive and effective representation, communication and information sharing. This mission
is achieved by developing mutually beneficial relationships and ongoing programs and
dialogues among its members and the governments of Malaysia and the United States of
America.

MACEE is one of 50 binational Fulbright Commissions worldwide and is the home to an

advising center which is the authoritative source in Malaysia for information on U.S.
education. MACEE is administering this scholarship program and is available to answer
questions from interested students and parents. We are located at:

18th Floor, Menara Yaysan Tun Razak,

200, Jalan Bukit Bintang,
55100 Kuala Lumpur, Malaysia
Tel: (03) 2166-8878, Fax: (03) 2166-1878

Nature of Scholarship
Funding from AMCHAM for the AMCHAM-MACEE Scholarship will be provided to a qualified
Malaysian student who has been admitted into a U.S. university for the Fall 2011
semester. The student must be a freshman applicant who has never attended a college or
university. Selection will be based upon academic merit and demonstrated financial need.
The scholarship is a one year partial award renewable depending upon grades.

How to Apply for Scholarship

1. Submit a completed application with updated financial documents.

2. Submit secondary school records, including all mark sheets, grade reports and leaving
certificates translated in English and certified as true copies.
3. Submit your TOEFL and SAT scores.
4. Arrange for completion of one reference form from a teacher and one reference form from a
religious or community leader.
5. Submit a copy of your IC or Malaysian Passport.
6. INCLUDE A COPY OF ACCEPTANCE LETTER AND I-20 FROM U.S. UNIVERSITY
7. Application deadline is May 30, 2011 at 4:30pm. Submit applications to MACEE.
All required documents must be submitted to MACEE by May 30, 2011.

Please note: If you have all the documents except the I-20 Form, you may submit your
application, and send a copy of the I-20 to MACEE after you receive the I-20.
 AMCHAM-MACEE Scholarship FOR OFFICE USE ONLY

Personal Information ( ) Application Form

( ) School
Examination Results
Legal Name: AHALYA A/P KALASILVAN_________________________________ ( ) Sch. Leaving Certificate
( ) TOEFL _________
Usually called: AHALYA Sex (M or F) ___FEMALE_____________
( ) SAT ___________
( ) I – 20
Handphone:_________________________ IC Number: _______________________ ( ) 2 Letter of Reference
( ) Malaysian IC
Email: ___________________________________________ Birthdate ___/___/___ ( ) Financial Documentation
dd./mm/yr.
Permanent HomeAddress:________________________________________________ ( ) Qualified
( ) Not Qualified
___________________________________________________________________________

City:____________________________________________ State:_______________________

Post Code: ____________________________________________

Telephone: __________________________ Fax: ___________________________

Parent Information
Father’s Full Name:
__________________________________________________________________________

Mother’s Full Name:

_________________________________________________________________________

Home
Address:_____________________________________________________________________________
_
City:_______________________________ State:___________________________ Post
Code:______________

Father’s Occupation:
__________________________________________________________________________

Name of Employer/Business:
___________________________________________________________________

Telephone: ________________________________ Fax:

____________________________________

Mother’s Occupation:
__________________________________________________________________________

Name of Employer/Business:
___________________________________________________________________

Telephone: ________________________________ Fax:

____________________________________

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Please assist us by indicating how you came to know about the AMCHAM Scholarship.
Conference/Education Fair
MACEE visit to your school/college
Advising or Walk-in at MACEE
MACEE website
Malaysia Scholarship website
Other: ________________________________________________________________________
[

Academic Information
Attach certified copies of your official transcripts from each secondary school attended and an
English translation of your exam results (SPM, STPM. O levels or A levels).

Secondary School
Attended:__________________________________________________________________

Address:___________________________________________________________________________

SPM:______ STPM:________ “0” Level:________ “A” Level:_________ IB:__________

Date Completed:_______________________________

Standardized Testing
List all dates on which you took the following tests:

TOEFL: Date Taken:________ Score:________

SAT I Date Taken:________ Score:________ ________ __________

Verbal Math Writing

SAT II Date Taken:_______________

Subject: ______________ Score: _________
Subject: ______________ Score: _________
Subject: ______________ Score: _________

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 Personal and School Activities
List your school, community, athletic or other activities below beginning with the one most
important to you. Include specific events and/or major accomplishments such as leadership
positions held, etc. If necessary, use an additional sheet of paper.

Activity Dates Hours per week Office(s) held or honor(s)

received

Work Experience
List any job you have had in the past three years, including summer employment.

Specific Nature of Work Employer Dates Hours per

week

Family Information
Please fill in the requested information in the following Table
Name of Brother/Sister Age of Sibling Describe what your sibling is
(List from oldest to Youngest currently doing and where they
including yourself) are (student or working)
1.
2.
3.
4.
5.
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 AMCHAM-MACEE Scholarship

Financial Information
To be completed by Applicant’s Financial Sponsor. Financial need will be judged from:

a) The income of both parents. Candidates must submit copies of income tax statements for 2010 and
salary
statements for the year 2010 or final year of work.
b) For parents who have retired, submit income tax forms from the last two (2) years of working life before
retirement. Annual retirement benefits, pension or retiree’s current income from other employment also
must be declared.

Sponsor’s
Name:____________________________________________________________________________

Sponsor’s Business or
Profession:_______________________________________________________________

Relationship of Sponsor to
Applicant:_____________________________________________________________

Annual Income of
Sponsor:_____________________________________________________________________

Sponsor’s
Address:___________________________________________________________________________

_____________________________________________________________________________________
_______

Tel: ______________________________ Fax: ____________________________

Affidavit of Support

I,_______________________________________________, do hereby affirm that I shall provide

educational and

living expenses for _____________________________________________________________as

indicated below.

I will provide matching funds in the amount of US $_____________________for the applicant for his/her
period of study in the United States. I certify that I have sufficient funds to cover this cost.

Signature of
Sponsor________________________________________________Date:________________________
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 AMCHAM-MACEE Scholarship
Personal Statement
We would like to know more about you personally than what the official documents reveal. The
personal statement is an important part of our evaluation. Describe some event in your life
that you feel helped shape your development or taught you an important lesson. Please
type your statement and put your name and IC number on the page. Please complete in no more
than 300 words.

Essay
Write an essay of no more than 300 words on the following topic: Define your academic goals
and objectives and explain how this scholarship will help you achieve your goals. Put
your name and IC number on each essay sheet that you submit with your application.

Additional Information
To which colleges and universities have you submitted applications?

1. _____________________________________ 4.___________________________________

2. _____________________________________ 5. ___________________________________

3. _____________________________________ 6. ___________________________________

To which colleges and universities have you been accepted?

1. _____________________________________ 4. ___________________________________

2. _____________________________________ 5. ___________________________________

3. _____________________________________ 6. ___________________________________

I certify that the information I have given on this application is complete and correct to the best of my knowledge.
I understand that I am responsible for supplying official records from schools I have attended and that such
records become the property of the AMCHAM-MACEE Scholarship and are not returnable to me. I understand
that falsification of my application or records is grounds for immediate cancellation of this scholarship.

Signature _____________________________________________________ Date ______/________/________

 AMCHAM-MACEE Scholarship

TEACHER’S REFERENCE

Applicant’s
Name______________________________________________________________________
Family Name Given Name

Secondary School_______________________________________________________Date: ___________

TO THE TEACHER: The student named above is applying for the AMCHAM-MACEE Scholarship. Please give us
information on what you think is important about the student’s academic skills and personal qualities for university. We
are grateful for your assistance. Please type your reference and place in the envelope provided by the student and
seal it. Sign you name across the seal and return to the applicant. Your evaluation is not to be read by the student.

Evaluation:

1. Describe the applicant with the first words that come to mind.

2. Academic characteristics:

3. How well do you think this student will adapt to university and the college community? Give examples
that illustrate your points.

Background information: How long have you known the applicant?

List courses you taught the applicant, and grade given.

Signature_____________________________________ School _____________________________________

Name (print)___________________________________ School Address ______________________________

Position_______________________________________ City _________________________ State__________

 AMCHAM-MACEE Scholarship
COMMUNITY REFERENCE

Applicant’s
Name______________________________________________________________________
Family Name First (Given)

Secondary School_________________________________________________________Date: ____________

Directions: Please comment on the student’s personal qualifications for attending a highly selective university in the
Unites States. What can you tell us about his/her maturity, interests, and ability to work with others.

TO THE REFEREE: The student named above is applying for the AMCHAM-MACEE Scholarship. Your input is to
assist the selection committee in better understanding the applicant as a person. Please type your reference and place
in the envelope provided by the applicant and seal it. Sign you name across the seal and return to the applicant. Your
evaluation is not to be read by the student.

How long and in what capacity have you known the applicant? ____________________________________________

Signature ________________________________ Name (printed) ______________________________________

Address _______________________________________________________________________________________
________________________________________________ Tel:______________________________________

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