Application for INGVAR KAMPRAD SCHOLARSHIP

1(2)

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Last name First name Present address for Correspondence (street/city/postal code/country)

Address valid until (date)

Phone: Email: Fax:

Valid until (date) Valid until (date) Valid until (date)

Contact address during May & June, if different from the address above. (street/city/postal code/country)

Date of birth Place of birth: Nationality: Female

Day

Month

Year

Male

Phone: Email: Fax: Motivation

School of Industrial Design, Lund University, Box 118, S-221 00 Lund, Sweden E- mail: industridesign@kansli.lth.se http://www.industrialdesign.lth.se

Application for INGVAR KAMPRAD SCHOLARSHIP

2(2)

Motivation (continue)

I certify that the information I have written on this form is correct, true and accurate to the best of my knowledge
Date ___________________________________________________ Signature of applicant _____________________________________________________

School of Industrial Design, Lund University, Box 118, S-221 00 Lund, Sweden E- mail: industridesign@kansli.lth.se http://www.industrialdesign.lth.se