Hegg Hoffet Application Form

This application is used to apply for a Graduate Women International Hegg Hoffet grant.

Step 1 of 4

All sections of the application form must be completed by the applicant for submission to be accepted for consideration.
Personal Data
Surname:*
First name:*
Date of birth:*
Place and country of birth:*
Nationality:*
Marital status*
Since what date have you lived in your current country of residence? (dd/mm/yyyy):
DD slash MM slash YYYY
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Fax number, including country code*
Your current address:*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone number, including country code:*
Email address:*
Email address (alternate):
Please list members of the family who currently live with you, including ages and relationships:*
Provide contact of family members*
Do you have a university degree?*

2. Education
High School:*
Post –secondary (include faculties and fields of study):*
Degrees (obtained or expected), with name of granting university:*
Professional qualifications, if any:*
3. Work experience, if any:
Work experience, if any:*
4. Languages:
(List known languages, and rate your abilities under each heading as Excellent, Good, Fair, Poor)
Understand*
Speak*
Read*
Write*
5. General information:
(Briefly describe your personal history, your current situation, and your plans or expectations for future study and work. Please write in English if at all possible. This page may only be submitted in French, Spanish, or German if you are fluent in any of those languages.)*
(Briefly describe your personal history, your current situation, and your plans or expectations for future study and work. Please write in English if at all possible. This page may only be submitted in French, Spanish, or German if you are fluent in any of those languages.)

6. Financial Information:
(Income per month in the currency of your present country of residence)
Average Income (net pay):*
Social Benefits, if any:*
Grant Income, if any:*
If married, husband’s average income, if any:*
Income of other relatives who live with you:*
Any other income (specify):*
Total monthly income from all sources:
Total income*
Please enter a number greater than or equal to 1.
Decimals should be comma seperated. E.g., 1000,00
Expenses (monthly):
Rent (or mortgage):*
Food:*
Utilities (heat, electricity, water, phone):*
Fees, insurance, taxes:*
Tuition, books:*
Childcare, if applicable:*
Clothing and shoes:*
Transportation:*
Other expenses (specify):*
Total monthly expenses:
Total expenses*
Please enter a number greater than or equal to 1.
Decimals should be comma seperated. E.g., 1000,00
Please specify which organizations are helping you at present, and how long this help will last:*
Amount of the minimal cost of living in your current country (monthly):
For one person:*
For a couple:*
7. Request for assistance from the GWI Hegg-Hoffet Fund:
How much money is needed? (Note: The maximum grant awarded is, in principle, 3000 Swiss francs in total.)*
For what will the money be used?*
specify in 10 words or less*
Please specify further information about above mentioned course/revalidation:
Such as title of the course:*
Name and place of university / graduate school at which the course will be taken:*
Any other particulars:
How long will the financial aid be required (usually less than two years)?*
To what other organizations have you applied for financial aid and what were the results of your applications?*

8. References:
Name, local address and phone number of three people who are not family members:
References*
Reference 1
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Name:*
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Surname:*
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Local address:*
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Phone number:*
Reference 2
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Name:*
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Surname:*
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Local address:*
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Phone number:*
Reference 3
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Name:*
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Surname:*
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Local address:*
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Phone number:*
9. If the request for assistance is granted, the applicant agrees to:
- Complete the course and /or certification.
- Will give periodical feedback to the GWI Hegg Hoffet Fund on her progress for the duration of the course.
- A short video or presentation that may be used by GWI for publicity purposes and during GWI’s meetings and/or conferences.
10. Verification:
Please attach a recent photo of yourself and documents verifying your nationality, refugee status, degrees obtained.*
Drop files here or

Max. file size: 3 GB.
Signature*
Date*
MM slash DD slash YYYY
Untitled*
- By submitting this application I, the applicant, agree to:
1. Complete the course/certification for which I am applying and provide certification/grade to GWI.
2. Providing periodic feedback to GWI of my progress for the duration of the course.
3. Providing a short video or presentation about my course/certification that will be used for GWI publicity purposes at their discretion.

Hegg Hoffet Application Form

Hegg Hoffet Application Form

Step 1 of 4

Personal Data

2. Education

3. Work experience, if any:

4. Languages:

5. General information:

6. Financial Information:

Total monthly income from all sources:

Expenses (monthly):

Total monthly expenses:

7. Request for assistance from the GWI Hegg-Hoffet Fund:

8. References:

9. If the request for assistance is granted, the applicant agrees to:

10. Verification:

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