The Mike Devenney Scholarship Fund

Scholarship application form

Please complete the following form and mail to:

Mike Devenney Scholarship Fund
1 Alnwickhill Road
Edinburgh
EH16 6LG


Your Surname

Your First Name

Date of Birth

Place of Birth

Age

Address for
Correspondence






Contact Telephone
Number

Home Address
(if different from above)





Email Address

University or HE Institution which matriculated

Course/Programme/Degree

Name of Referee 1


Address of
Referee 1




Relationship to Referee 1

Name of Referee 2


Address of
Referee 2




Relationship to Referee 2




Supporting Statement
(use additional sheets if necessary