APPLICATION FORMFOR HQ EXAMINATION PERSONNEL

Instructions:
This form may take you 10 minutes to complete.You will need the following information to fill in the form:
  • Your personal particulars
  • Your educational records
  • Your employment records

(A)Application for

Chief Presiding Examiner
Presiding Examiner /Invigilator
Liaison Officer

(B)Personal Particulars

Full Name in NRIC/Passport
ID Number / ID Type / NRIC (Pink) NRIC (Blue) Passport
Contact Number / Residential: / Mobile:
Residential Address / Singapore ( )
Email Address

(C)Educational Records

Highest Education Qualification
(Please submit a photocopy)
Subject specialisation,
if applicable

(D)Current Employment

Date Joined / Date Left / Name of Organisation / Designation / Reason for leaving
Do you intend to leave this employment: / Yes No

(E)Past Employment – In Chronological Order (Latest Employment First)

Date Joined / Date Left / Name of Organisation / Designation / Reason for leaving

298 Jalan Bukit Ho Swee, Singapore 169565 |

Updated 11 May 2015

(F)Relevant Work Experience

  1. Have you conducted any invigilationduty before?
/ Yes No
If you answered `Yes’ to the question above, please provide details, including the names of the institutions and your roles:

(G)Other Information

1. / Do you have any existing medical condition, physical impairment or substance dependence (i.e. dependence on alcohol, drugs, etc, excluding prescription by a certified medical professional)? / Yes No
2a. / Do you have existing criminal record(s)in Singapore or overseas (excluding parking offences or spent records)? / Yes No
2b. / Have you been charged with any offence in a court of law in Singapore or in any other country for which the outcome is pending (excluding parking offences)? / Yes No
3. / Are you currently under police investigations in Singapore or overseas? / Yes No
If you answered “Yes” to any of the questions, please provide details:

(H)Declaration

(1)I hereby give my consent to the Singapore Examinations and Assessment Board (SEAB) to:
(a) / Obtain and verify information from or with any source (including third parties) as may be deemed appropriate by SEAB for the purposes of assessing my application.
(b) / Share my personal data set out in this application form with other Government agencies for the purposes of this application.
(2)I declare that all the information given by me in this application and any additional documents attached hereto are true to the best of my knowledge and that I have not wilfully suppressed any material fact. I accept that if any of the information given by me in this application is in any way false or incorrect, my application may be rejected, any offer may be withdrawn or terminated summarily by SEAB.
By signing below, I hereby certify that I have read and understood all of the clauses above and that I agree to all of them.
Signature of Applicant: / Date:
Please submit your application form and additional document, if any, via:
Fax to the following number: / OR / Mail to the following address
62724076
Attention: Exam Operations Department / To: / Singapore Examinations and Assessment Board
298 Jalan Bukit Ho Swee
Singapore 169565
Attention: Exam Operations Department
We regret that only shortlisted applicants will be called for interview.

298 Jalan Bukit Ho Swee, Singapore 169565 |

Updated 11 May 2015