APPLICATION TO WORK PART-TIME IN NUS (For Undergraduate and Graduate Students)
RO.1022/03
PART 1 :
To be completed by Student
i. Student Particulars
Name (Underline surname) Dr/Mr/Mrs/Mdm/Miss Birth Date (dd/mm/yyyy) Department Matric/Registration No. Programme Type Undergraduate/Grad Coursework/Research* Degree Gender Male / Female*
Citizenship (Please tick accordingly [ ] ) [ ] Singaporean/SPR (NRIC No.: ____________________ ) [ ] Others (FIN No: _________________________ )
Singapore Mailing Address: Contacts Telephone No.: Handphone No: Postal code (
)
Email Address:
ii. Proposed Appointment Appointment: UST / USR / GST (Scheme A) / GST (Scheme B) / GSR * Period [(Please state semester (eg. Sem I, 2003-04) or
period from: ____ to ____ (dd/mm/yyyy)].
Duties (Please give a brief description)
Total no. of proposed hours:
. Yes / No*
Are you currently holding another part-time appointment in NUS? If “Yes”, please state: Total no. of working hours per week : _________________
Current Rate of payment : $ ________________
iii. For Graduate Research Students Only
If you are an NUS Research Scholarship holder, please state: Award start date:
(dd/mm/yyyy) Award expiry date: (dd/mm/yyyy) Is your proposed appointment is at the same department as your registered department? Yes / No* Please get approval from your research supervisor by completing below prior to handing the form to the processing officer of the Department where you will be employed.
I agree to the proposed appointment. Name of Supervisor: Department: * To delete as appropriate. Signature : Date:
Signature of Student : ______________________________________
Date: __________________
-2-
PART 2 :
To be completed by Supervisor/Principal Investigator employing the Student (for USR/GSR scheme only)
I recommend/do not recommend* the proposed appointment. If appointment is under research grant (please ensure availability of sufficient funds), please state: WBS No: Project title: Project start date: End date:
Type of grant: * University/NSTB/NMRC/Others (please specify):
Name: Department:
Signature : Date:
PART 3 :
To be completed by Approving Officer (Faculty/Department where student is employed)
I approve/do not approve* the proposed appointment. Rate of payment: $ per hour Total remuneration: $
Name: Designation:
Signature : Date:
* To delete as appropriate.
C:PTT-APPLICATION FORM/GBH/29.01.2004