FOR SUBMISSION VIA COURSE LECTURERS ONLY

APPLICATION FOR PUBLIC TRANSPORT INDUSTRY SCHOLARSHIP

APPLICANT
NITEC/Higher NITEC/Polytechnic/ University*
Please state name of current institution:
Year of Study: 1 / 2 / 3 / 4 *
Latest GPA:
Course of Study:
Choice of Employer:
(Please tick √ accordingly)
□ SBS Transit Limited
□ SMRT Corporation Limited
SECTION 1: PERSONAL PARTICULARS ( In Capital Letters)
Name (as in NRIC/Passport)
Please underline surname
NRIC Number / Date of Birth (DD/MM/YYYY)
Gender
Male/Female* / Citizenship
Race / Email Address
Home Address / Contact Number (Home)
Contact Number (HP)
Mailing Address (if different from Home Address)
SECTION 2: NATIONAL SERVICE RECORD
(if applicable)
Status (Please tick √ accordingly)
□ Awaiting Enlistment □ Currently Serving □ Completed □ Disrupted □ Exempted □ Not Applicable
Date of Enlistment
(DD/MM/YYYY) / Operational Ready Date/ Disruption Date* (DD/MM/YYYY) / Unit/Vocation
SECTION 3: EDUCATION HISTORY
(Primary to Tertiary)
Name of School / Country / Duration of Course
(From MM/YYYY to MM/YYYY) / Highest Academic Qualification Attained
SECTION 4: RESULTS
GCE ‘O’ Levels or equivalent
(if applicable) / GCE ‘N’ Levels or equivalent
(if applicable)
Subject / Grade / Subject / Grade
SECTION 5: APPLICATION SUBMITTED/APPROVED FOR OTHER SCHOLARSHIPS/AWARDS/BURSARIES
(if applicable)
Name of Scholarship /Award/Bursary / Year applied
SECTION 6: CO-CURRICULAR ACTIVITIES
Name of CCA / Position(s) held / Year
SECTION 7: OTHER QUALIFICATIONS/AWARDS
Qualification/Award / Institution / Year of Award
SECTION 8: ESSAY
In less than 250 words, please write a short paragraph on your interest in Engineering and/or in joining the public transport industry. Essays are to be type-written only.
SECTION 9: ADDITIONAL INFORMATION
Please indicate ‘Yes’ or ‘No’. If Yes, please give details in the space provided. / Please tick (√) accordingly
Yes / No
  1. Have you ever suffered or are you suffering from any medical condition, illness, disease, mental illness, substance dependence, physical impairment or have been referred for psychiatric treatment for anxiety, depression, stress, eating disorder etc? If yes, please state details:

  1. Do you have a criminal record in Singapore? By this, we refer to only a criminal record of a conviction under the Registration of Criminals Act. If yes, please state details:

  1. Have you ever been convicted in a court of law in any country? If yes, please state details:

  1. Have you been charged with any offences in a court of law in Singapore or in any other country for which the outcome is pending? If yes, please state details:

  1. Are you aware of being under any current police investigations in Singapore or in any country following allegations made against you? If yes, please state details:

  1. Are you currently benefiting from any sponsorships/grants/bonds? If yes, please state details:

Additional Questions for Public Transport Industry Scholarship
How did you get to know about our scholarship?
DECLARATION
I declare that the information given by me in this application is true to the best of my knowledge and that I have not withheld any information. I understand that if any entry is false, my application will be invalid and void.

Applicant’s Name Applicant’s Signature Date