PRINCIPALS AWARDS @ TAYLOR'S COLLEGE SUBANG JAYA TAYLOR'S COLLEGE SRI HARTAMAS AWARDS

NAME:

2013
Be Part of the Learning Revolution

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APPLICATION FORM
A PERSONAL PARTICULARS (PLEASE USE BLOCK LETTERS. ALL INFORMATION IN PART A MUST BE FILLED)

Full Name: (as per IC/ Passport)

E-mail Address: Home Tel No:

(Note: We will be sending you updates by email and SMS. Please do not leave these fields blank)

Mobile Phone No:

Home Address: Postcode: City: State: IC/ Passport No: Gender: M F

B TYPE OF AWARD
(Please choose only one and indicate with a tick () in the boxes provided below.) Principals Awards 2013 @ Taylors College Subang Jaya Programmes offered: - Cambridge A Levels (CAL) - Canadian Pre-University (CPU) - South Australian Matriculation (SAM) Taylors College Sri Hartamas Awards 2013 Programmes offered: - Cambridge A Levels (CAL) - International Baccalaureate Diploma Programme (IBDP) - South Australian Matriculation (SAM)

FAMILY INFORMATION

Name of Parent / Guardian 1: Relationship: Occupation: Office Tel No.: E-mail Address of Parent / Guardian: Name of Parent / Guardian 2: Relationship: Occupation: No. of Siblings Still Schooling: Mobile Phone No.:

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Town:

ACADEMIC QUALIFICATIONS
Year:

School / Institution:
Note: Please attach your Form 4 (Grade 10) and Form 5 (Grade 11) school examination results. (CERTIFIED TRUE COPY of school report card)

EXTRA- / CO-CURRICULAR ACTIVITIES

POSITIONS HELD Chief Editor YEAR 2011 EXPERIENCE GAINED Published school magazine

NO. GAMES / SOCIETIES / OTHERS 1 2 3 4 5 6 e.g. Editorial Board

NO. SPECIAL ACHIEVEMENTS / HONOURS & RECOGNITION 1 2 3 4 5 6

Note: 1) Please complete Section E in detail. You may attach a separate sheet, if required. 2) Certified true copies of certificates are NOT required in this section.

YEAR 2011

EXPERIENCE GAINED Public speaking skills

e.g. State Level Public Speaking Competition Champion

ESSAY

1. Please prepare an essay of not more than 300 words, typed on a separate sheet of paper. Topic: The future is here. How will the iPad and other digital devices change my learning experience? 2. Please indicate your full name and school on the top right hand corner. 3. Please attach your essay with this application form.

G TERMS AND CONDITIONS

1. Scholarships on offer are for January 2013 (SAM, CPU, CAL) and July 2013 (IBDP) intakes only. 2. Students receiving scholarships/ financial assistance/ bursaries from other bodies are not eligible for the Principal's Awards 2013 / Taylor's College Sri Hartamas Awards 2013. 3. All scholarship applications must be endorsed by the School Counsellor/ Assistant Principal/ Principal as a form of recommendation from the school. 4. All shortlisted candidates will be required to attend an interview in August and September 2012 at the designated town nearest to you. 5. All applicants may be invited for an experience day in August 2012 at Taylors Colleges campuses prior to the interview. 6. All applications must reach Taylors College by 16 July 2012. Late applications will not be entertained. 7. The Terms and Conditions of the Principals Awards 2013 / Taylors College Sri Hartamas Awards 2013 may be changed and modified from time to time as deemed appropriate by Taylors College. The details of Terms and Conditions of the scholarship will be made known to the successful applicants. 8.On all matters pertaining to the Principals Awards 2013 / Taylors College Sri Hartamas Awards 2013, the decision(s) of the Bursary Committee of Taylors College shall be final and binding. The number of scholarships awarded is subject to the final decision of the panel of interviewers.

INSTRUCTIONS FOR SUBMISSION

Deadline for submission: 16 July 2012 Submit your application form and documents by post to Taylors College at the following address: Principal's Awards 2013 @ Taylor's College Subang Jaya Taylor's College Sri Hartamas Awards 2013 Registry, Records and Scholarship Unit Student Central Taylors College No. 1, Jalan SS15/8 47500 Subang Jaya Selangor Darul Ehsan. Tel: 03-5636 2641

DECLARATION BY APPLICANT

I, (IC/ Passport No.) , declare that the information provided by me is true and correct. I understand and agree that Taylors College reserves the right to vary or reverse any decision regarding this application made, on the basis of incorrect or incomplete information. I hereby agree to abide by all Terms and Conditions set by Taylors College.

Name of Applicant: Date:

Signature of Applicant:

CHECKLIST FOR DOCUMENTS TO BE ENCLOSED

Completed application form One passport-sized photo Certified true copy of school report card (Form 4 (Grade 10) and Form 5 (Grade 11) examination results) Certified true copy of IC/ Passport Essay

K VERIFICATION BY SCHOOL
Name of School Counsellor/ Assistant Principal/ Principal: Designation: Signature: FOR OFFICE USE ONLY Application verified & checked by: Signature: Name: Date:
*All information is correct at the time of printing May 2012.

Date:

School Stamp: