Our reference: JSS/StudentAwards/20 ___/____

Application for School and SAC Sponsored Awards

To be completed by Applicant

Part 1:Student Particulars
Name (in Full) / NRIC No. / FIN & Citizenship Status / Gender / Class
Name (in Chinese, where relevant) / Co-Curricular Activity / Contact Details
Tel:
Mobile:
Email:
Address
Part 2:Details of Application
Type of Award
ALP Mentorship
Urban Greening
Urban Farming
Sustainable Water Management
inSPire
Aesthetics & Culture
Science & Technology
Media & Infotech
Project COMPassion
Sports / Nature of Award (where relevant)
Individual
Team
Other Applications(please specify if you are applying for other awards)
Yes
If yes, please specify which Award
______
No
Details of Team Members (to be completed for Team Awards only)
Name in Full / Class
Proposed Project Title
Brief Synopsis of Project(include why you/ your team are keen to pursue this project, what you/ your hope to achieve, and how you/ your team plan to contribute back to the school or community)
Motivation Behind the Proposal
Targets/ Goals Set
Nature of Contribution to the School or Community
Part 3:Project Details
Timeline / Details / Proposed Funding / Outcome/ Deliverables
*Please attach a separate sheet of paper if the space provided is insufficient.
part 4 Declaration
I hereby declare that all the information provided above are accurate as of the date of submission of this application.I authorise the release of any information submitted by me to any person, institution or corporation for the purpose of considering my application for the project.
I agree to ensure that the programme planned would not be in conflict with my core CCA training, competition schedules and school enrichment programmes.
Name & Signature / Date

* Please circle accordingly

For School Use Only

Administrative Follow-up
Status of Application
Successful/ Unsuccessful* / Notes
Follow-up by
(Indicate Name of Teacher Mentor)
Processed by
Name / Date

*Please circle accordingly

Should you require clarifications or assistance in putting up the application form, please do not hesitate to approach the following teachers:

Type of Award / Teacher(s)
ALP Mentorship / Mr Eric Tan, Mr Timothy Boay
inSPire / Mr Lam Chee Leong, Mdm Zheng Jieyun
Project COMPassion / Mr Stanley Tan, MsShuryani
Sports / Mr NurQarnain, Ms Ong Wei Chen

All completed forms to be submitted to the General Office by the stipulated deadline.

“When you're surrounded by people who share a passionate commitment around a common purpose, anything is possible.”

Howard Schultz

1 | PageUpdated January 2017