You have entered a secured site Application for admission to an undergraduate course at the National University of Singapore in Academic Year 2016-2017 Please check your application carefully before submission. The Office of Admissions cannot be held responsible for the accuracy of your application. (This application form is only applicable for students of polytechnics located in Singapore, not for former or existing university students) The application form consists of the following sections. Please complete all sections. 1. Personal Particulars 9. Disabilities and Special Needs 2. Contact Information 10. Next-of-Kin Information 3. Academic Qualifications 11. Other Information 4. University/Tertiary Education 12. Personal Identification Number 5. Outstanding Achievements 13. Application Fee 6. Choice of Courses 14. Financial Aid 7. National Service(NS) 15. Declaration 8. Consideration as Mature Candidate Fields that are marked with * are mandatory. Preparation advice for completion of application form: To cut down on your application time, you are advised to have the following documents ready: 1. Secondary Education results GCE O Level results slip to fill in subjects and grades; ITE Certificate (if applicable); SPM results (if applicable) 2. High School Education results (if applicable; especially for international qualifications) 3. Polytechnic results to count the number of grades obtained for all semesters or first 5 semesters (for final semester students) 4. Essay of 2000 characters (approximately 300 words) under the Outstanding Achievements section. It is advisable that you craft the essay in Microsoft word document first before copying it into this section. This section is an opportunity for you to list the activities that you have been involved besides your academic work. If you choose not to fill in this section, you will not be considered under the Discretionary Admissions Scheme. 5. National Service in Singapore only (if applicable) for Date of Enlistment and Operationally Ready Date The completion of the application form takes about 15 to 20 minutes if you have the above documents ready. 1. Personal Particulars Full Name * Given Name * Family Name * LENG) (full name as printed on your NRIC/passport/Birth Certificate) (e.g. KOK LENG) Note: Click here for guide on how to key in Given Name (E.g. TAN) Note: Click here for guide on how to key in Family Name Date of Birth * / / (dd / mm / yyyy eg. 08 / 02 / 1989) Gender * Citizenship * Singapore Permanent Resident Yes No (Please do not select Yes if you are a Singapore Citizen.) NRIC number/fin Passport Number Marital Status* Race / Ethnic Group* Religion* S (e.g. TAN KOK (To be filled in by non-singapore Citizen. If you are a Malaysian, please enter your 12-digit Malaysian I/C number) S
2. Contact Information Postal Address * (Incomplete postal address will result in non-delivery of letter/s sent out by National University of Singapore) Block/HouseNo. * (e.g. APT BLK 42) Street Name/Building Name * State/City Country * Postal Code Email * Alternate Email Home Telephone* Handphone 3. Academic Qualifications Unit No. (e.g. #12-34) (You do not need to fill in "Singapore" here if you are providing a Singapore address) (Please ensure your email address will be in-use for at least another 12 months) (Please ensure your alternate email is different from the above) (Please do not fill in country & area codes for Singapore number; for the 'number' field, please do not put hyphen or leave space in-between numbers, eg. Contact number should be keyed in as 12345678) (Please do not fill in country & area codes for Singapore number; for the 'number' field, please do not put hyphen or leave space in-between numbers, eg. Contact number should be keyed in as 12345678) Please ensure that you enter the correct grades/results here as your admission outcome will be adversely affected by inaccurate information. Secondary Education Name of Secondary School City/Country From To Examination Year Taken If you have taken the GCE 'O' Level examination on more than one occasion, please indicate the better grade of the subjects obtained based on the best 2 sittings. EG: For Maths grade of B3 in 1983 and Maths grade of A2 in 1984, fill in grade A2 for Maths. You should submit the results slips for all sittings taken for our verification. If you have taken the GCE 'N' Level examination, you are NOT required to fill in the subjects and grades obtained for your 'N' Level results. If you have taken both Singapore-Cambridge GCE 'N' Level and Singapore-Cambridge GCE 'O' Level examination, please select "Singapore-Cambridge GCE 'O' Level" and fill in the subjects and grades obtained from your GCE 'O' Level results. If you were from the Integrated Programme (IP), please indicate the grades obtained (e.g. B or B3) and not the grade point average. Please also submit the Year 4 IP results slips for our verification. Subjects English Marks / Grade Obtained Maximum Marks / Grade Possible
Name of ITE (if applicable) City/Country From To If you have attained any ITE qualification, please send in results slips for verification. Leave blank if not applicable. Polytechnic Education* Polytechnic Student number/ Admission Number Name of polytechnic Singapore Polytechnic If you have indicated your diploma as OTHERS, please provide name of diploma here Course (If the diploma you have is not listed here, please select the option "Others") In addition to your diploma course, are you doing / have attain an additional certificate (Diploma-Plus / Certificate Programme)? If yes, please indicate and submit documentary proof Singapore Polytechnic Note: If you are still doing the above additional certificate and do not have the documentary proof, please indicate in the checklist. Admission Month & Year Graduation Month & Year If you had graduated from your polytechnic or institution in 2015 or earlier, please select the activities that you are currently/have been engaged in. (Applicable only to those who have graduated) Number of years taken for diploma course Number of semester results presented in this application *Note: If you are currently doing OR have completed your internship in the first semester of your final year and will only receive your final two semester results in March/April 2016, please indicate the number of semesters completed prior to the start of your internship. (Applicable only to those who have not graduated) Diploma taken Full Time Part Time Did you repeat any year/semester in the diploma course? No Yes Did you change course during the course of study? No Yes Were you on medical leave/leave of absence for 1 semester or more during your course of study? Were you awarded the Certificate of Merit / Diploma with Merit / Diploma with Distinction for the diploma course? (applicable to those who have already graduated) I. Were you awarded Prizes/awards in any year of study? No Yes No Yes No Yes Not Applicable II. Were you awarded any medal/award in your final year of study? (applicable to those who have already graduated) No Yes Not Applicable (Please submit the relevant documents for verification if you have indicated "Yes" for either or both of the above.)
If you are a graduating student completing your final semester of study, please indicate your cumulative GPA for the first 5 semesters. If you have a GPA, you are not required to fill up the grades obtained for all semesters below. For graduated students who do not have a GPA, please indicate 0 in the GPA field and fill up the grades obtained for all semesters below. Final GPA Number of Dist, AD, A+ Number of A, A- Number of B+, B, B- Number of C+, C, C- Number of D+, D, D- Number of E Number of F Number of P Additional Information Please provide, if available Date Taken Marks / Grade Obtained IELTS (Please input the (Please enter Overall score for Academic testing only) band component score only) (Please enter Writing component score only) (Please enter Reading component score only) TOEFL Paper Internet EL1119 MUET SAT Critical Reading Math Writing SAT Subject Tests Subject ACT Composite Score Advanced Placement (AP) Subject Students who are offering the Indian Standard 12 qualification may fill in their IIT/AIEEE (if applicable) below: AIEEE Rank
State Rank Country Rank IIT Rank State Rank 4. University/Tertiary Education Country Rank Are you a current / former (regardless of whether you have or have not graduated) student of the National University of Singapore (NUS), Nanyang Technological University (NTU), Singapore Management University (SMU), Singapore University of Technology & Design (SUTD), Singapore Institute of Technology (SIT), SIM University (UNISIM) and/or any other tertiary institutions (except polytechnics in Singapore)? (Please click here for more information) Yes No Note: 1. If your answer to the above question is 'Yes', please DO NOT use this form. Instead, you would belong to the category of "Transfer Applicants", and you would have to apply under this category of application. More details can be found at: http://www.nus.edu.sg/oam/apply/transfer/admissionreq/bya-admission.html. 2. You may like to note that any false declaration to this section may render this application invalid and NUS may at its discretion withdraw any offer of admission made to you on the basis of false declaration. 5. Outstanding Achievements This section is an opportunity for you to list the activities that you have been involved in besides your academic work. A list of activities that we may take into consideration is provided below. Please provide relevant details. If you wish to include particulars of referees, you should seek their consent before listing them. Please also inform them that the University might contact them for clarification. You should indicate your achievements in the International Olympiad (Biology, Chemistry, Mathematics, Physics and Informatics) competitions under 'Activity 1'. You should leave it blank if you have not participated in any of the indicated Olympiads. You may wish to provide other relevant details under 'Activity 2 and 3'. You should also include a personal statement in the space provided in this section. The statement could elaborate on the achievements in the activities you had participated and how they relate to your interest in for the course of study you have chosen. Do note that information declared in this section may be used in the selection of freshmen awards and scholarships and for admission to NUS under the Discretionary Admissions Scheme. It is therefore important that you complete this section carefully. Activity 1* Level of achievement Name of activity/ organisation/employer* Level Position Held From* To* Name of contact person (if available) Position of contact person Telephone number Fax number You may wish to provide other relevant details under 'Activity 2 and 3'. You may also wish to elaborate on your involvement and achievements in these activities in an essay in this section. You must submit the relevant records/supporting documents for the information you provided. Activity 2* Level of achievement Name of activity/ organisation/employer*
Level of activity School level of activity Position Held Not Applicable Not Applicable Activity 3* Essay From* To* Name of contact person (if available) Position of contact person Telephone number Fax number Level of achievement Name of activity/ organisation/employer* Level of acitivity School level of activity Position Held From* To* Name of contact person (if available) Position of contact person Telephone number Fax number Not Applicable Not Applicable This section is an opportunity for you to elaborate on the information you have provided earlier. You may discuss a special talent, a personal experience or an activity that you have been involved in that is relevant to the course you are applying for admission. As your essay is limited to only 2000 characters, do present your ideas in a focused and thoughtful manner. 2000 6. Choice of Courses There will be TWO parts in this section: (a) and (b). In (a), please tell us your choice of Single Degree courses in order of your preference. You must complete (a) before you proceed to (b) to indicate your interest in the Double/Concurrent Degree programmes. You need to complete (b) only if you are interested in the double/concurrent degree programmes. a) Single Degree Courses State your choice of course in order of preference. We will consider your choice in the order that you have indicated. For example, if you do not qualify for your first choice, we will consider you for your second choice and so forth, at no disadvantage. You may choose fewer than 5 choices but do not repeat the choices. For the latest update on courses, please refer to http://www.nus.edu.sg/oam/courses/course.html. 1st Choice* 2nd Choice 3rd Choice 4th Choice 5th Choice Note: For each choice, there is a Drop-Down-Menu comprising all single-degree courses which NUS offers. Application for the Music course should be filed separately. Please refer to the Yong Siew Toh Conservatory of Music (NUS) website at
http://music.nus.edu.sg. Students must indicate Dentistry as their first or second choice if they wish to be considered for admission to this course. Students must indicate Medicine as their first or second choice if they wish to be considered for admission to this course. Students must indicate Nursing as their first, second or third choice if they wish to be considered for admission to this course. Students must indicate Architecture as their first, second or third choice if they wish to be considered for admission to this course. Students must indicate Industrial Design as their first, second or third choice if they wish to be considered for admission to this course. Students must indicate Law as their first or second choice if they wish to be considered for admission to this course. The only exception granted is where students place Law as their third choice with Medicine and Dentistry as their first two choices. b) Double/Concurrent Degree Programmes Please fill in this section if you are interested in a double/concurrent degree programme. Note that: 1. If you wish to apply for a double/concurrent degree programmes, you must include at least one of the faculties/schools offering the double/concurrent degree programme as one of your choices in (a). 2. The faculties / schools offering direct admission to double / concurrent degree programmes are Arts & Social Sciences (for Communications & New Media), Business and Computing. 3. To be considered for the Computer Science Courses & Master of Entertainment Technology (Carnegie Mellon University) double degree programme, you must have listed Computer Science Courses as one of your choices in (a). 4. To be considered for the Computer Science Courses & Grad Scientiae Magistri (Scientia Computatoria) (Brown University) concurrent degree programme, you must have listed Computer Science Courses as one of your choices in (a). 5. To be considered for the Arts & Social Sciences (NUS) and Arts (Sciences Po) double degree programme, you must have listed Arts & Social Sciences as one of your choices in (a) AND the double degree programme as your choice in (b). Additionally, you are required to read carefully its application procedures, including the application window, at http://www.usp.nus.edu.sg/nussciencespo/info/apply.html. You will be evaluated for admission to a double/concurrent degree programme if you are successful in gaining admission into a faculty /school that offers one of the double/concurrent degree programmes. Some double/concurrent degree programmes require a selection interview. Only shortlisted candidates will be informed to attend the interview(s) for the double/concurrent degree programmes. You may be shortlisted for one or more interviews if you indicate more than one choice for your Double/Concurrent Degree Programme options. Please note that Double/Concurrent Degree Programmes are highly competitive. 1st Choice 7. National Service (NS) in Singapore [applicable to Singapore Citizens and Singapore Permanent Residents only] Please click here for more information on NS Status before completing this section. Please choose "Not Applicable" if you do not need to or are not serving National Service in Singapore. If you are waiting to be enlisted for NS, please select "Registered/Waiting to be enlisted" for your "NS Status." Unless you have indicated your NS status as "Not Applicable", "Registered" or "Exempted", you are required to indicate your NS date. If you are currently Registered/Waiting to be enlisted, it is important that you indicate your date of enlistment if it is available. National Service Status * Enlistment Date (Not applicable if your NS status is "NA" or "EXEMPTED" or "Registered".) ORD/Disruption Date If you are exempted from National Service, you are required to submit the necessary documents (endorsed by MINDEF) to Office of Admissions. Please click here for more information on submission of supporting documents. 8. Consideration as Mature Candidate If you are at least 25 years old as of 1 July 2016 with at least 4 full years of relevant full-time working experience, would you like to be considered as a Mature Candidate? Yes No If you have answered "Yes", please complete both Parts (a) and (b) in this section. (a) Particulars of Referrals Please provide 2 referrals (compulsory) from at least one employer. Referrals must be at supervisory level and above. Referee 1 Name of Company Name of Referee
Telephone number (Country & area codes are required only for non-singapore number) Referee 2 Name of Company Name of Referee Telephone number (Country & area codes are required only for non-singapore number) (b) Employment History Please indicate the name of the company and length of service with each employer which makes up the 4 full years of relevant working experience, starting from the most current employer. Name of Company Position From To (c) SAT Test Scores Please provide your SAT Test scores in the Academic Qualifications Section of this Form if you have indicated that you wish to be considered as a Mature Candidate. 9. Disabilities and Special Needs Have you had or do you have any communicable diseases, mental illness, colour blindness, and/or disabilities (including but not limited to chronic illnesses, visual or other physical constraints or limitations) which may or may not cause you to require special assistance or facilities while studying at the University? * Yes No If yes, please provide details below and submit medical documents and/or other supporting documents. Medical conditions Medical condition 1: Medical condition 2: Medical condition 3: Please provide more details on your medical condition in the box If you require any form of special assistance and/or facilities if admitted to the University, please provide details below. Note: This information will enable the University to develop a complete profile of an applicant and determine whether he/she might need additional resources in his/her studies. The University does not, however, guarantee the provision of special aid (financial or otherwise) to any student. 10.Next-of-Kin Information Please provide a contact person in case of an emergency. Name of Next-of-Kin / Guardian * Relationship with Applicant* Occupation * 250 250 250 1000
Telephone * Handphone / Pager (country & area codes are required only for non-singapore number) (country & area codes are required only for non-singapore number) 11.Other Information Have you ever been convicted of an offence by a court of law or a military court (court martial) in any country or are there any court proceedings pending against you anywhere in respect of any offence? Are you currently, or have you ever been, charged with or subject to disciplinary action for any type of misconduct, scholastic or otherwise, at any educational institution? Are you currently, or have you ever been, under investigation or subject to enquiry in respect of any misconduct, scholastic or otherwise, at any educational institution? If your answer to all the above questions is No, please click No below. * Or No If your answer to any or all of the above questions is Yes, please click Yes below and also provide a full statement of the relevant information in the box below and/or on a separate sheet of paper (and attach the relevant documents). Yes 12.Personal Identification Number Enter an Admission PIN (8 alpha-numeric characters) (case sensitive)* Re-enter your Admission PIN (8 alpha-numeric characters) (case sensitive)* (eg ABCD1234) Please keep your PIN confidential. Your PIN is important and you will need it to access the following online facilities related to this application. Uploading of supporting documents Updating of choice of courses before 21 February 2016 Updating of contact information before 21 February 2016 Online status enquiry Online reply to NUS' offer of admission Online appeal E-Payment via Credit Card 13.Application Fee A non-refundable application fee of SGD10 is payable. Please select one of the following modes of payment Credit card (Visa/MasterCard/Amex only). Payment can be made immediately via the web link located at the acknowledgement page after submitting your application. Bank draft/cheque made payable to 'National University of Singapore'. NETS at the Office of Admissions, NUS. DBS/POSBank ATM at any DBS/POSBank ATM machines islandwide. * Payment must be made by 21 February 2016. Applications without full payment will not be processed. 14.Financial Aid 100 NUS offers Financial Aid schemes such as loans, bursaries and work-study opportunities in order to help financially needy students meet their study expenses in NUS. Do you intend to apply for Financial Aid offered by NUS to support your studies in NUS? * Yes No
15.Declaration I hereby declare that all information provided by me in connection with this application is true, accurate and complete. I understand that any inaccurate, incomplete or false information given or any omission of information required shall render this application invalid and NUS may at its discretion withdraw any offer of acceptance made to me on the basis of such information or, if already admitted, I may be liable to disciplinary action, which may result in my expulsion from NUS. And I hereby authorise NUS to obtain and verify any part of the information given by me from or with any source (such as Ministry of Education), as it deems appropriate. I declare and warrant that for any personal data of other individuals disclosed by me in connection with this application, I have, prior to disclosing such personal data to NUS, obtained the appropriate consent from the individuals whose personal data are being disclosed, to permit NUS to collect, use and disclose such personal data for purposes related to this application, as set out fully in the Personal Data Notice & Consent. I agree that all such information provided by me in connection with this application may be disclosed to authorised NUS personnel or third parties on a need-to-know basis for purposes related to this application, as set out fully in the Personal Data Notice & Consent. Third parties include (i) the Ministry of Education, other government agencies or statutory bodies or non-government agencies authorised to carry out specific Government services or duties and (ii) persons or organisations providing students with financial aid. I have read and agree to the terms and conditions contained in the Personal Data Notice & Consent. I agree to receive marketing, advertising and promotional information from NUS via postal mail, electronic mail, SMS or MMS and/or fax. Yes No I agree to receive marketing, advertising and promotional information from NUS at my telephone number provided above via voice call / phone call. Yes No Continue Copyright 2001-08 National University of Singapore. All Rights Reserved. Company Registration Number: 200604346E Terms of Use Privacy Non-discrimination