Cambodia Scholar Application 2026-27 at SHE-CAN

1. First (Given) Name *

2. Last (Family) Name *

3. Email *

4. Phone *

5. Age *

6. Birthdate (MM/DD/YYYY) *

7. Birth City *

8. Country of Citizenship *

9. Where you live currently (including address if available) *

10. High School: Name, address, and contact information of high school attending/graduated from *

11. Which option below best describes where you grew up? *

12. Your Story: Tell us about you and what makes you unique, about your family, background, and any challenges you or your family have overcome. Share any details about your life and how you’ve grown into the person you are. *

13. Career Goals: 12. Career Goals: Tell us about an area of study or type of career you are interested in right now. What about that profession interests you? What experiences have you had or steps have you taken to prepare and learn about that type of career? What impact could make in your country make in your country in that field? *

14. Activities: Please tell us about all of the activities that you have participated in. What clubs, organizations, sports, school activities, etc. were or are you involved in and what leadership roles did you play? *

15. Tell us about a time you brought people together or supported a group. What role did you play, and how might you do something similar in the SHE-CAN community? *

16. What evidence of climate change have you personally observed in your community? How have people, from leaders and policy makers to your families and friends, responded? (Not more than 500 characters) *

17. What’s a problem you’ve seen in your school/community that you believe more women in leadership positions could help solve or make decisions about? *

18. After you graduate from college in the US, what kind of work do you aspire to do in Cambodia, and how could it make a difference for others? *

19. Graduation: What is the date of your high school graduation or expected date of graduation? *

20. Attendance: Was there ever a period (weeks, months, whole school year) where you were unable to attend school? If so, why? (e.g. lack of funds, illness, during COVID etc.) *

21. Rank: Please tell us your high school class rank. (What number were you academically in class: 1st, 2nd, 5th, 23rd, 55th?) If your school does not have ranks, please put "NA." *

22. National Exam: If you have taken the National Exam, please tell us your percentile rank and grade. (e.g. 97.632 B) Note: we are aware the 2020 exam was cancelled. If you graduated in 2020, please type "NA." If you will graduate this year and expect to take the exam later, please put "TBD." *

23. University: If you are currently enrolled in or have graduated from a college or university, please tell us: 1) the school name 2) school address 3) school contact information 4) number of credits/units you've taken 5) for how long you have been taking classes 6) your expected graduation date 7) your concentration or major

24. Exams: If you have taken any of the exams listed below, please indicate which exams you have taken. (You can select more than one by checking multiple boxes.) *

25. Exams: If you have taken any of the exams listed above, please tell us the composite score you received and the year that you took the exam for each of the exams. (e.g. I took the IELTS in 2019 and my score was 6.0)

26. Family Income and Jobs: Please list every member of your household whose income contributes to your support and describe in detail: 1) the job they have, meaning their role or job title 2) the name of the company or place they work, and 3) details about the type of work they do to earn the money that supports you. Must answer all 3 questions for each person and be specific *

27. Monthly Income: Please estimate your total average monthly household income in U.S. dollars. (Please ensure you are providing income for one month, not one year, so if you know your household’s annual income, divide by 12.) How much does each member of your household earn every month? If their income is inconsistent or seasonal (like farming or tourism), please explain here. *

28. Family Savings: How much does your family currently have in savings? In your answer please describe the type of savings. Some examples are:money in the bank, investments in real estate or cash at home. Please clarify if it is U.S. Dollars or Riels. If your family doesn’t have any savings, please put 0. *

29. Primary Caretaker's Name (What is the name of the person responsible for you?) *

30. Primary Caretaker's Relationship to you (Is this person your mother, father, brother, uncle, adoptive mother, adoptive father, other?) *

31. Primary Caretaker's Phone Number and/or email address for a home visit

32. Secondary Caretaker's Name (Who is the second person responsible for you?). *

33. Secondary Caretaker's Relationship to you (Mother, father, brother, aunt, etc.) *

34. Secondary Caretaker's Phone Number and/or Email Address

35. Your Household: Please list everyone in your household and their relationship to you. (e.g. Chantha - Father, Mouy - Mother, Bopha - Sister, Rith - Brother, Sophea - Grandmother) *

36. Are you married, pregnant, or do you have any children or dependents? If so, please explain. *

37. Possessions: What appliances or electronics do you have at home (e.g., refrigerator, fan, TV, washing machine)? *

38: Home: Please describe your home. How many rooms does it have? Do you have your own room, or share? Do you have electricity? How do you access clean water? Please feel free to share more details about your home and household. *

39. What kind of transportation does your family use most often? (e.g., walk, bicycle, motorbike, car) *

40. Do you have access to a computer or tablet at home? If so, is it your own or shared? *

41. How many times have you used a computer? *

42. How do you usually access the internet? Please explain any barriers you may face (e.g. data cost, location with wifi, poor network connection, no computer, etc) *

43. Have you ever used Zoom, Skype, or another video conferencing feature? If yes, how often? *

44. HS Funding: Who pays/paid your high school fees? If you were awarded a scholarship to help fund your high school education, please describe your scholarship (e.g. amount provided annually, percent of costs covered by scholarship). *

45. University Funding: If you are currently in university, who pays for your university fees? If you were awarded a scholarship to help fund your education, please describe your scholarship (e.g. amount provided annually, percent of costs covered by scholarship).

46. Funding U.S. University: How much money could your parents or family members contribute to pay for your college education in the U.S. each year? Please provide an estimate of the realistic amount your family can afford. If they cannot afford to contribute, please put 0 here. *

47. Scholarships: What other international scholarships have / are you applying for? Please list and explain all schools, scholarship opportunities / programs you have applied for, been accepted into, or plan to apply for AND the status of your application. (Pursuing other opportunities will not hurt your chances of acceptance in SHE-CAN, but not disclosing them may affect your eligibility.) *

48. How did you hear about SHE-CAN? What organization or person(s) suggested you apply? (For example, Education First Cambodia, Harpswell Foundation, US Embassy, professor or list social media.) *

49. Do you know anyone involved in SHE-CAN? If you do (scholars, candidates, program staff, etc.) please tell us who you know by name and also tell us your relationship to them (friend, family member, etc.) *

50. Do you have a sponsor, personal mentor, extended family member, coach, school counselor or teacher who is going above and beyond to help you reach your personal potential and become a leader? This can be anyone that has made a significant impact on you and your success. If yes, what support have they given you and in what ways have they impacted you? *

51. Did anyone or any tool (like ChatGPT or other artificial intelligence) help you complete this form? If so, please explain how they helped you (e.g. someone typed in the answers, someone proofread for me, someone lent me their computer, etc). *

52. Questions: Do you have any questions or issues with this application you need us to know about? Please explain here. IMPORTANT: THERE IS NO FEE TO APPLY TO THE SHE-CAN PROGRAM.

A. HS Transcripts: Please upload your transcripts from grades 10, 11 and 12. If they are not in English, please provide an officially or personally translated version along with the original. **We cannot consider your application or invite you to an interview without seeing your grades.** If not available, please upload a text document explaining why and when you expect to receive copies of them. *

B. National Exam: If you have taken the National Exam, please upload your National Exam Results. **Without a record of your National Exam Score we cannot invite you to an interview. ** If not available, please upload a text document explaining why and when you expect to receive a copy of your score. *

C. University Transcripts: If you attend (or previously attended) a post-secondary college or university, please upload transcripts/grades from each semester/term you completed. Please explain if you are or will be enrolled in classes in the next 6 months. **Without your grades we cannot invite you to an interview.**

D. Score Reports: If you have taken the ACT, SAT, IELTS, TOEFL and/or Duolingo, please upload copies of your scores for each exam you have taken.

Optional Video: If desired, upload a 2-minute video to tell us why you believe you should be selected for a leadership program designed to help emerging leaders in Cambodia reach their full potential. (We recognize there are technological barriers to creating a video, so this question is entirely optional. Choosing not to submit a video will not impact your chances of being selected for SHE-CAN.)

See all the jobs at SHE-CAN here: http://shecan.recruiterbox.com/jobs

Application Form