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APPLICATION FORM FOR ASMI-MARINE ENGINEERING SCHOLARSHIP
PART 1: STUDENT’S PARTICULARS
Name:
Gender:
NRIC/Passport Number:
Nationality:
Date of Birth (dd/mm/yy):
Race:
Citizenship:
Home Tel:
Handphone:
Mailing Address:
Email Address:
For Male Applicant who have completed National Service (please tick √ accordingly and specify)
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Yes
Vocation:
Rank Held:
No
State reason:
Exempted
State reason:
PART 2: FAMILY MEMBERS’ PARTICULARS
Number of Family Members:
(parents & siblings including self):
Particulars
Number of Family Members who are
working:
Total Monthly Household Income
(gross):
Father/Guardian
Mother
Name
Age
Occupation
Company’s name
Monthly Income (gross)
PART 3: EDUCATION
Entry into Higher NITEC into Mechanical and Electrical Engineering Design/Mechanical Engineering/Electrical
Engineering after completion of (please tick √ accordingly):
Secondary Education
Year of Graduation
Name of School
GCE Results (Points)
GCE ‘O’ level
GCE ‘N’ level
ITE Education
NITEC
Higher NITEC
Year
Course of Study
PART 4: PART TIME EMPLOYMENT AND OTHER VACATION JOBS
Please state nature of job held and duties involved:
PART 5: CO-CURRICULAR ACTIVITIES
CCA Participation in School or other External Activities (please state the level of participation, eg National
Player, Chairman, Committee Member, etc):
PART 6: FINANCIAL AID AND OTHER SCHOLARSHIPS
Are you in receipt of any of the following financial aid/scholarships: (* please delete accordingly)
1.
CPF Approved Education Scheme
Yes/No*
2.
Tuition Fee Loan
Yes/No*
3.
MENDAKI Tertiary Education Fee Subsidy Scheme
Yes/No*
4.
PSC Tuition Fee Loan Scheme
Yes/No*
5. Other Awards (external scholarship/bursary or study loan)
If yes, please specify the award received and the year that it was obtained:
Yes/No*
PART 7: DECLARATION
I declare to the best of my knowledge and belief that the particulars furnished in the application and the
documents attached are true and I have not wilfully suppressed any material fact.
__________________________________________
Name
________________________________________
Signature & Date
PART 8: SUPPORTING DOCUMENTS
Enclosed are the following documents in support of my application:
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Transcripts of NITEC examinations results in ITE.
Copy of GCE ‘O’ Level results.
Copy of GCE ‘N’ Level results.
ASMI / V2-2008