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					                  NUS RAFFLES HALL
                  BURSARY APPLICATION INSTRUCTIONS


Instructions:

1.    Applicants are to fill in all sections of the form for complete application. If any section of the application form
      does not apply to you, insert “N/A”. Incomplete sections will result in the application being void. False/
      inaccurate information submitted, or omission of required information will also render the application invalid.

2.    Each applicant is to submit only ONE copy of the application form. In the case of duplicate submissions, only
      the latest submission would be considered.

3.    All supporting documents are to be attached and submitted with the application form. Supporting documents
      that are not in English must be accompanied by an English translation of the document.

4.    Only submit photocopies of supporting document; Raffles Hall is not liable for the loss of any original
      supporting documents.

5.    One recent passport size photograph must be pasted on the application form.

6.    Raffles Hall reserves the right to reject any application which it deemed unsuitable, incomplete or
      inaccurately completed. No queries will be entertained.
                                                                                                th
7.    Deadline for applications: All applications should reach Raffles Hall Office by 1200 11 November 2011.

8.    Alternatively, applicants can mail their completed application form to:

                                                        Raffles Hall
                                              National University of Singapore
                                                  19 Kent Ridge Crescent
                                                    Singapore 119278

9.    Applicants sending their applications by snail mail are reminded to take into account postal working hours,
      and that the application must reach Raffles Hall office by the stipulated deadline to be deemed valid.

10. Applicants can use the following checklist to ensure that all of the supporting documents are completed and
    ready for submission.

S/N       Task                                                                                        Done?
1.        Checked for eligibility criteria for Raffles Hall Bursary?
2.        Completed all sections of the Bursary Form?
3.        Pasted a recent passport size photograph on the application form?
4.        Attached one verified, photocopied set of the following supporting documents on the
          application form?
          -    Income tax statements/ pay slips/ any supporting documents verifying income
          -    Any supporting documents verifying assets/ liabilities/ other bursaries/
               scholarships/ financial aid
          -    NUS academic transcript or A’ Levels certificate/ Polytechnic academic
               transcript if NUS academic transcript is not applicable
          -    Co-curricular activities records of preuniversity/ university, if available
          -    Letters of support/ References/ Testimonials, if available
          -    Records of any other achievements
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5.        Send the completed application form to Raffles Hall office by 1200 6 October 2011.
          Alternatively, mail to:
                                                     Raffles Hall
                                          National University of Singapore
                                               19 Kent Ridge Crescent
                                                 Singapore 119278
                 NUS RAFFLES HALL
                 BURSARY APPLICATION FORM



SECTION A: PERSONAL PARTICULARS
Name: (as in NRIC/ passport)



NRIC/ FIN/ Passport Number*:
(with official ref.) (*cancel where appropriate)

                                                                         Affix passport size
                                                                             photo here
Home Address:



Matriculation Number:                    Gender:



Date of Birth:                           Place of Birth:          Nationality/ Citizenship:



Race:                                    Contact Number (home):   Contact Number (mobile):



NUS Email:



Personal Email:
SECTION B: FINANCIAL STATUS
1.     All applications are to be accompanied by employer’s certification letter of the latest income tax statement.
2.     Information provided must include all immediate family members i.e. parents/guardians and siblings
       (regardless of their marital status). If you are married, please include your spouse and children.
3.     Use separate sheets, if necessary.

B1. TOTAL MONTHLY FAMILY INCOME
Full name of immediate  Age   Marital                      Relationship to       Occupation/ Name        Gross Income/
family members                Status                         applicant           of business (if self-    Pension per
(a) Staying in the same                                                              employed)              month
household




(b) Not staying in same            Age      Marital        Relationship to       Occupation/ Name           Monthly
household but contributing to               Status           applicant           of business (if self-    contribution
family                                                                               employed)




                                                                                                     #
                                                         TOTAL MONTHLY FAMILY INCOME :
#
    If your family income is zero, please state how your family is supported without income.
B2. ASSETS AND ALTERNATIVE SOURCES OF INCOME
Please list all assets and alternative sources of income not captured by IRAS statements/ pay slips (e.g. bank
interests, dividends on equities etc). Leave “monthly contribution” blank if not applicable. Use separate sheets, if
necessary.

Assets                                                                                    Monthly contribution




B3. LIABILITIES
Please list all liabilities (e.g. outstanding housing mortgage, debts, university/education fees, medical bill, etc).
Leave “monthly liability” blank if not applicable. Use separate sheets, if necessary.

Liabilities                                                                               Monthly liability




B4. OTHER AWARDS/ FINANCIAL ASSISTANCE
If you are a current recipient of any of the following awards/ receiving financial aid, please furnish details of award/
financial aid. Use separate sheets, if necessary.

B4.1. RECIPENT OF ANY SCHOLARSHIP/ BURSARIES/ LOANS/ FINANCIAL AID FROM NUS
   Name of Award and Organization  Date of Application Duration of Award Total Amount Granted




B4.1. RECIPENT OF ANY SCHOLARSHIP/ BURSARIES/ LOANS/ FINANCIAL AID FROM OTHER
ORGANIZATIONS
   Name of Award and Organization  Date of Application Duration of Award Total Amount Granted
SECTION C: ACADEMIC PARTICULARS
1.   All applications are to be accompanied by the applicant’s NUS academic transcript. The academic transcript
     can be obtained from Student Service Centre, Yusof Ishak House Level 1.
2.   If the applicant is in his/her first semester of study, his/her A Level Certificate/ Polytechnic academic transcript
     will suffice.

Faculty:                                                     Course and Year of Study:



Major(s)/ Specialization(s):                                 Minor(s):
(insert “N/A” if not applicable)                             (insert “N/A” if not applicable)



Current Cumulative Aggregative Point (CAP):
(insert “N/A” if applicant has yet to attain a CAP)


Academic Awards Obtained:
(e.g. Book Award, Dean’s List etc)




SECTION D: CO-CURRICULUM ACTIVITIES
1.   List down activities (includes cultural groups, sports, and committees) that you have served, or are currently
     serving. Please accompany application with all verified records of co-curriculum activities, if available.
2.   For section D2 and D3, please include both hall and university commitments/ achievements.
3.   Use separate sheets, if necessary.

D1. PREUNIVERSITY ACTIVITIES
   Name of Activity        Position                       Period Served                  Achievements/Medals
D2.1. UNIVERSITY ACTIVITIES – COMMITTEES/ CULTURAL
 Name of Committee          Position           Year                     Achievements




D2.2. UNIVERSITY ACTIVITIES – SPORTS
   Name of Sports        Position      Year           Level             Achievements/ Medals
                                              (e.g. University, Hall)




D3. OTHER LEADERSHIP EXPERIENCE
SECTION E: LETTERS OF SUPPORT/ REFERENCES/ TESTIMONIALS (OPTIONAL)
1.   Please attach any letters of support/ references/ testimonials (no maximum limit).
2.   Each document must provide the contact number of the referee, as well as the signature of the referee for
     verification purposes.

                            Name of Referee                                         Relationship to Applicant




SECTION F: DECLARATION

I declare that the information stated in this application and the attachments are true to the best of my knowledge
and belief, and that I have not willfully suppressed any material fact. I understand that any attempt to give false
information would result to my application being void.




Date: _________________________                    Signature of Applicant: ______________________________
FOR OFFICAL USE ONLY

Applicant Name               Bursary Outcome


                                          GRANTED   NOT GRANTED


Bursary Amount Awarded       Bursary Duration




Remarks




DECISION SUPPORTED BY

MASTER, RAFFLES HALL         SCRC REPRESENTATIVE, RAFFLES HALL
HO CHEE KONG                 Name:



Signature:                   Signature:



Date:                        Date:

HALL MANAGER, RAFFLES HALL   JCRC PRESIDENT, RAFFLES HALL
LEONG SIEW TENG              Name:



Signature:                   Signature:



Date:                        Date:

				
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posted:11/7/2011
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