Education Fund Application

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I certify that I will report only accurate information, I will report in US dollar values and English language, and will provide any needed documents upon request. *

First name*

Middle name*

Last name *

Email *

Confirm Email *

Phone number * Please enter country code with number

Year in medical school *

University *

University ID number * please insert no dashes, inaccurate number might exclude your application

University admission year * This is the year you started at your University

Cumulative score * Please enter a number from 0 to 100. please enter either 100% or 4.0 scale

# of semesters with honor list/s*

Please enter a number from 0 to 12. How many times/semesters you were recognized by your university as being on honor list?

How many brothers are studying in universities? *

Please enter a number from 0 to 10. Please don't include married brothers.

Average tuition per credit hour for brothers .*

Please enter a number from 0 to 1000 . Please report in US dollars. please add all and divide by total, e.g., brother #1 pays $50 per credit hour, and brother #2 pays $100, then the write down 75 '50+100/2' .

How many sister are studying in universities? *

Please enter a number from 0 to 10. Please don't include married sisters.

Average tuition per credit hour for sisters *

Please enter a number from 0 to 1000. Please report in US dollars. please add all and divide by total, e.g., sister#1 pays $50 per credit hour, and sister#2 pays $100, then the write down 75 '50+100/2'.

How many total brothers and sisters? *

Please enter a number from 0 to 20. Please don't include yourself or married siblings.

Your Tuition per credit hour *

Please enter a number from 0 to 1000. How much does it cost you per academic hour? please report in US dollars.

Number of credit hours per semester "spring or fall"*

Please enter a number from 0 to 30. How How many credit hours do you plan to register for the coming semester?/semesters you were recognized by your university as being on honor list?

Tuition per semester spring or fall" *

How much will it cost you for the coming semester? please subtract any scholarships or other waived tuition. please don't include summer semester. Please report in US dollars

Have you received or will you receive any scholarship from *

REACH foundation United Holy Land Fund United Palestinian Appeal PAMA Other None

Regarding the scholarship you have received, how much was it? *

please select '0' if you didn't receive any scholarships?

Where do your family live *

City/town where your family live *

Father Alive? *

Father's Occupation *

Currently does not work Retired Dead other

father income *

Mother Alive?*

Mother's Occupation *

Currently does not work Retired Dead other

Monthly income*

Other income 'brothers / Sisters living in same household' ? *

Name three references, references need to be adults, from where your family live, not among your relatives, and not university students. Failure to reach contacts or any discrepancy in information provided will result in the cancelation of your application .

First reference

Name *

Phone number *

Occupation *

Second reference

Name *

Phone number *

Occupation *

Third reference

Name *

Phone number *

Occupation *

Why should PAMA approve your application for the scholarship? This is the only section where you are allowed to write in ARABIC *

By clicking submit below you certify that all the information provided above are true and accurate. Any discrepancy or inaccurate information will automatically cancel your current and future applications