APPLICATION FOR SPD STUDY AWARDS

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1 Eligibility Criteria Applicants must satisfy the following eligibility criteria and conditions: 1. Must be a Singapore Citizen or Singapore Permanent Resident 2. Possess good academic records 3. Satisfy the admission criteria of the tertiary institutions 4. Enrolled or to be enrolled into the relevant fields of study of the tertiary institution Documents to Be Submitted with the Application Form 1. Photocopy of front and back of Identity Card 2. Educational records and transcripts 3. Resume 4. Testimonials, if any.

2 Please write or type in clear BLOCK LETTERS. Complete all sections and indicate NA for items that are not applicable. SECTION 1: PERSONAL PARTICULARS Applicant s Name (Please underline surname) NRIC No. Gender Race Date of Birth (DD/MM/YYYY) Country of Birth Nationality Address Home Contact Number Mobile Number Address Mailing Address (if different from current address) SECTION 2: NATIONAL SERVICE RECORD (if applicable) Have you completed National Service (NS)? Yes No Status Date of Enlistment Rank If you have not completed NS, have you obtained deferment? Yes No SECTION 3: EDUCATION Name of School / College / Polytechnic Graduated Country Duration of Course (From MM/YYYY to MM/YYYY) Highest Academic Qualification Attained SECTION 4: RESULTS GCE O Levels (or equivalent) GCE A Levels (or equivalent) Subject Grade Subject Grade

3 DIPLOMA Subject Grade Subject Grade SECTION 5: UNIVERSITY APPLICATION (If you are applying for University, please complete this section and submit a copy of your university acceptance letter upon request.) Choice of University Course of Study Status of Application Expected Entry Year: SECTION 6: UNIVERSITY (To be completed by current undergraduates only. Please attach examination results / transcripts.) Institution Start Date Course Completion Date Duration Country Year of Study (as at application date) Cumulative GPA Course of Study SECTION 7: APPLICATION FOR OTHER SCHOLARSHIPS / AWARDS / BURSARIES (if applicable) Name of Scholarship / Award / Bursary Year applied Status of application SECTION 8: CO-CURRICULAR ACTIVITIES (CCA) Institution Position Period (MM/YYYY to MM/YYYY) Description SECTION 9: OTHER QUALIFICATIONS / AWARDS Qualification / Award Institution Year

4 SECTION 10: VOLUNTEER EXPERIENCE Period Organisation (MM/YYYY to MM/YYYY) APPLICATION FOR SPD STUDY AWARDS Responsibilities SECTION 11: WORKING EXPERIENCE Period Organisation (MM/YYYY to MM/YYYY) Job Title and Responsibilities SECTION 12: REFEREES Full Name Occupation Contact Period Known SECTION 13: PARTICULARS OF FAMILY MEMBERS Name Age Relationship Occupation SECTION 14: OTHER INFORMATION Language Proficiency Spoken: Written: About Yourself 1 Have you ever been detained by the police, CID, CPIB, or any Yes No other government law enforcement institution of convicted in a court or law of Singapore or any country? (exclude parking offences)

5 2 Have you been or are you under financial embarrassment which includes: (a) Bankruptcy proceedings Yes No (b) Undischarged bankrupt or a judgement debtor Yes No (c) Unsecured debts and liabilities of more than 3 months of last-drawn pay Yes No (d) Signing of a promissory note or an acknowledgement of indebtedness Yes No 3 Have you even been discharged, suspended, dismissed or terminated Yes No by any of your previous employers? 4 Have you suffered, or are you suffering from any medical condition, illness, Yes No disease, mental or physical impairment? 5 Do you have any relatives/friends or know anyone who is/are an employee(s) Yes No or a board member(s) of SPD? 6 Have you previously applied for this scholarship? Yes No If yes, please provide details on date of previous application: How did you hear about the SPD Study Award? SPD Website School BrightSparks Friends Others (please specify): SECTION 15: In 200 words, tell us why you are applying for the SPD Study Awards and how it will help you achieve your aspirations.

6 DECLARATION I declare that all information in this application (and attached documents, if any) are true to the best of my knowledge and belief, and I will not willfully suppressed any material facts. I acknowledge that I will be disqualified, or if accepted, my scholarship will be terminated without any notice if any information is found to be untrue or material facts have been willfully suppressed. Applicant s Name Applicant s Signature Date

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