Академический Документы
Профессиональный Документы
Культура Документы
( 29579 - T)
Course of Bachelors Degree Applied For / Currently Pursuing How did you know about our scholarship advertisement?
The STAR Harian Metro Gamuda's Website Facebook
A. PERSONAL DETAILS
Full Name:
(as appears in NRIC / Passport)
Other Name (if any): Date of Birth: Race: Permanent Address: Age:
NRIC No: Gender: Marital Status: Mailing Address (if different from Permanent Address):
C. ACADEMIC QUALIFICATIONS (Please enclose certified copies of your results, certificates & testimonials)
SPM DETAILED RESULTS *STPM / A-LEVEL / MATRICULATION / DIPLOMA / FOUNDATION STUDY DETAILED RESULTS
Year :
Year :
Subject
Grade
Subject
Grade / CGPA
(b) If you are currently in University / College, please provide the following details and attach your Letter of Offer: Period Name of University / College Course of study Expected to Joined (mth&yr) complete
If not, have you applied for any scholarship award / study loans? Name of Sponsor(s) Faculty / Course
Coverage Amount
F. EXTRA-MURAL ACTIVITIES
(i)
- FORM 4 ONWARDS (To enclose certified copies of certificates) School Responsibilities (e.g. prefect, monitor) Year Name of School / College / University Post Held From To
Type of Responsibility
(ii)
Club / Society (excluding sports activities) Name of School / College / University Year From To Name of Club/Society/ Uniformed Body Post Held
(e.g. President/Secretary/Treasurer/AJK)
(iii)
N N N N N (iv) Others (debate, camps, essay writing competition, quiz, chess, arts, drawing etc.) Year Name of School / College / University Type of Competition From To
St St St St St
D D D D D
C C C C C
Sc Sc Sc Sc Sc
N N N N N
2013 Application Form
St St St St St
D D D D D
Page : 2
C C C C C
Sc Sc Sc Sc Sc
H. FAMILY BACKGROUND
(a) Name of Father: Occupation:
(Please enclose a photocopy of the latest EA form / Salary slips / Pension card) Age: Handphone No:
Company's name (if retired, state former company): Company's Address: Salary / Income / Pension per month RM: Office Tel No: (b) Name of Mother: Occupation: Company's name (if retired, state former company): Company's Address: (c) Brothers & Sisters (Including those already married) Name Relationship Married/ Single Salary / Income / Pension per month RM: Office Tel No: Age Occupation. If studying state School / University Salary / Income per month (RM) Age: Handphone No:
(d) Total family income per month How much financial assistance can your family offer you per month for studies and living expenses? (e) Property (e.g. land, house, shoplot, etc.) Type Estimated Value (RM)
RM RM
(f) Other income (e.g. rent, funds, etc.) Type Estimated Value (RM)
(g) Commitments / Debts Do you or your parents have any debts or other financial commitments to a bank or any other institutions? If yes, please specify: Name of Bank / Institution Nature of Commitment (e.g. loan, mortgage, etc.) Amount (RM)
Page : 3
NAME :
DATE : ________________
Page : 4
J. OTHER MATTERS
Hobbies:
Ambition: Language & Dialects: List your language & dialect ability and tick the relevant boxes spoken spoken spoken written written written Yes / No spoken spoken spoken written written written
Do you have any relatives or friends working in this Company or its subsidiaries? If yes, Name : Relationship :
Have you ever been convicted of any criminal offence ? Yes / No Do you suffer from any physical handicap / illness ? Yes / No Have you joined National Service? Yes / No
If yes, please state If yes, please state If yes, please state year
I declare that the information given above is correct, complete and true. I understand that any false information or documents given may render me liable to disqualification even if accepted. Willful suppression of any material will similarly be penalised.
Date
Applicants are reminded NOT to send original certificates and testimonials when submitting application form. The completed application must reach us not later than 10 May 2013 either by hand or mail. We would not be responsible for any loss in delivery or mail. Incomplete application will not be considered. Write "Scholarship Award " and indicate the course applied for on the top left hand corner of the envelope.
4 5
Your checklist: Please indicate attachments (It is compulsory to show proof of financial needs)
Certified Results
(SPM, STPM / equivalent)
Certified Certificates
(Form 4 & above only)
Certified Testimonial
Photograph
Written Essay
OTHERS
Page : 5