NUS BUSINESSSCHOOL

SCHOLARSHIP/Financial AID

Application Form

for

Full-time

Undergraduate students

NUS BusinessSchool

Undergraduate Studies, BIZ 1, 2-7

15 Kent Ridge Drive

Singapore 119245

Important Information and Instructions
1) / This application form is ONLY for existingNUS Business School students who are applying for scholarship/financial aid in AY2016/2017
2) / If you are holding or applying for another bursary or scholarship, you will not be allowed to hold concurrent awards if you are successful in this application.
3) / By accepting the offer, all information submitted in relation to your application will be securely held at NUS BusinessSchool and related offices. Such information will be treated confidentially but may be used for the benefit of NUS, its constituent parts and agencies contracted by NUS for purposes directly related to the interests of NUS.
Your particulars may also be used,as appropriate, for direct marketing purposes which include development and fund raising activities, or disclosed to external organizations for purposes of surveys or publicity for NUS' scholarship/financial aid programmes. If you do not wish your particulars to be used as aforementioned, please contact the Development Office at the School.
4) / All supporting documents should be submitted with the application summary document to the Undergraduate Studies at the School. You are also required to retain a copy of this document for record purposes. The processing of your application will be delayed if the required supporting documents are not submitted by the stipulated deadline.
1.PERSONAL PARTICULARS
Name
(As in identity card / passport) / Student No.
(if applicable)
Nationality
Race
/
/ Identity No. /Passport No.
Home Address /
/ Home Tel No.
MobileTel No.
/
Email Address
(please provide your NUS email address if you are an existing student)
Faculty
Course / Year of Study
Major(s)

*Please delete if not applicable

2) Financial Information
2.1 / For current employed persons, all information on earnings must be accompanied by employer's certification letter/pay slip/latest income tax statement.
2.2 / Information provided must include all immediate family members and dependents. If you are married, please include your spouse and children.
2.3 / The monthly gross income must include all income or receipts from the following: a) salary; b) rental; c) interest/investment income; d) pension; e) withdrawals from the Central Provident Fund (CPF) or its equivalent.
a) Family Members staying with applicant.
(Include siblings who are studying abroad in this section.)
Family Member 1
Name: / Age: / Relationship to Applicant:
Highest Educational Level : / Marital Status:
(please delete if not applicable)
Single / Married / Divorced / Widowed / Separated / Employment Status:
(please delete if not applicable)
Employed / Self-employed / Retired / Unemployed / Housewife / Student / NSman
Job Title:
*E.g.Director, Manager, Admin Assistant, etc. / Job Sector:
*E.g. IT, Food & Beverage, Retail, etc / Name of Company/School:
*For employed/self-employed persons, indicate company’s name. For student, to indicate school/institution
Monthly Gross Income (SGD):
Last Drawn Salary date*(DD/MM/YYYY):
* For salaried employee, enter amount from latest salary slip or employer's letter
* If self-employed, please submit Declaration Form A1
* If retired/unemployed, please submit Declaration Form A2
Family Member 2
Name: / Age: / Relationship to Applicant:
Highest Educational Level : / Marital Status:
(please delete if not applicable)
Single / Married / Divorced / Widowed / Separated / Employment Status:
(please delete if not applicable)
Employed / Self-employed / Retired / Unemployed / Housewife / Student / NSman
Job Title:
*E.g.Director, Manager, Admin Assistant, etc. / Job Sector:
*E.g. IT, Food & Beverage, Retail, etc / Name of Company/School:
*For employed/self-employed persons, indicate company’s name. For student, to indicate school/institution
Monthly Gross Income (SGD):
Last Drawn Salary date*(DD/MM/YYYY):
* For salaried employee, enter amount from latest salary slip or employer's letter
* If self-employed, please submit Declaration Form A1
* If retired/unemployed, please submit Declaration Form A2
Family Member 3
Name: / Age: / Relationship to Applicant:
Highest Educational Level : / Marital Status:
(please delete if not applicable)
Single / Married / Divorced / Widowed / Separated / Employment Status:
(please delete if not applicable)
Employed / Self-employed / Retired / Unemployed / Housewife / Student / NSman
Job Title:
*E.g.Director, Manager, Admin Assistant, etc. / Job Sector:
*E.g. IT, Food & Beverage, Retail, etc / Name of Company/School:
*For employed/self-employed persons, indicate company’s name. For student, to indicate school/institution
Monthly Gross Income (SGD):
Last Drawn Salary date*(DD/MM/YYYY):
* For salaried employee, enter amount from latest salary slip or employer's letter
* If self-employed, please submit Declaration Form A1
* If retired/unemployed, please submit Declaration Form A2
Family Member 4
Name: / Age: / Relationship to Applicant:
Highest Educational Level : / Marital Status:
(please delete if not applicable)
Single / Married / Divorced / Widowed / Separated / Employment Status:
(please delete if not applicable)
Employed / Self-employed / Retired / Unemployed / Housewife / Student / NSman
Job Title:
*E.g.Director, Manager, Admin Assistant, etc. / Job Sector:
*E.g. IT, Food & Beverage, Retail, etc / Name of Company/School:
*For employed/self-employed persons, indicate company’s name. For student, to indicate school/institution
Monthly Gross Income (SGD):
Last Drawn Salary date*(DD/MM/YYYY):
* For salaried employee, enter amount from latest salary slip or employer's letter
* If self-employed, please submit Declaration Form A1
* If retired/unemployed, please submit Declaration Form A2
Family Member 5
Name: / Age: / Relationship to Applicant:
Highest Educational Level : / Marital Status:
(please delete if not applicable)
Single / Married / Divorced / Widowed / Separated / Employment Status:
(please delete if not applicable)
Employed / Self-employed / Retired / Unemployed / Housewife / Student / NSman
Job Title:
*E.g.Director, Manager, Admin Assistant, etc. / Job Sector:
*E.g. IT, Food & Beverage, Retail, etc / Name of Company/School:
*For employed/self-employed persons, indicate company’s name. For student, to indicate school/institution
Monthly Gross Income (SGD):
Last Drawn Salary date*(DD/MM/YYYY):
* For salaried employee, enter amount from latest salary slip or employer's letter
* If self-employed, please submit Declaration Form A1
* If retired/unemployed, please submit Declaration Form A2
Family Member 6
Name: / Age: / Relationship to Applicant:
Highest Educational Level : / Marital Status:
(please delete if not applicable)
Single / Married / Divorced / Widowed / Separated / Employment Status:
(please delete if not applicable)
Employed / Self-employed / Retired / Unemployed / Housewife / Student / NSman
Job Title:
*E.g.Director, Manager, Admin Assistant, etc. / Job Sector:
*E.g. IT, Food & Beverage, Retail, etc / Name of Company/School:
*For employed/self-employed persons, indicate company’s name. For student, to indicate school/institution
Monthly Gross Income (SGD):
Last Drawn Salary date*(DD/MM/YYYY):
* For salaried employee, enter amount from latest salary slip or employer's letter
* If self-employed, please submit Declaration Form A1
* If retired/unemployed, please submit Declaration Form A2
(b) Family Members not staying with applicant but contributing to the family
Family Member 1
Name: / Age: / Relationship to Applicant:
Highest Educational Level : / Marital Status:
(please delete if not applicable)
Single / Married / Divorced / Widowed / Separated / Employment Status:
(please delete if not applicable)
Employed / Self-employed / Retired / Unemployed / Housewife / Student / NSman
Job Title:
*E.g.Director, Manager, Admin Assistant, etc. / Job Sector:
*E.g. IT, Food & Beverage, Retail, etc / Name of Company/School:
*For employed/self-employed persons, indicate company’s name. For student, to indicate school/institution
Monthly Contribution (SGD):
Last Drawn Salary date*(DD/MM/YYYY):
* For salaried employee, enter amount from latest salary slip or employer's letter
* If self-employed, please submit Declaration Form A1
* If retired/unemployed, please submit Declaration Form A2
Family Member 2
Name: / Age: / Relationship to Applicant:
Highest Educational Level : / Marital Status:
(please delete if not applicable)
Single / Married / Divorced / Widowed / Separated / Employment Status:
(please delete if not applicable)
Employed / Self-employed / Retired / Unemployed / Housewife / Student / NSman
Job Title:
*E.g.Director, Manager, Admin Assistant, etc. / Job Sector:
*E.g. IT, Food & Beverage, Retail, etc / Name of Company/School:
*For employed/self-employed persons, indicate company’s name. For student, to indicate school/institution
Monthly Contribution (SGD):
Last Drawn Salary date*(DD/MM/YYYY):
* For salaried employee, enter amount from latest salary slip or employer's letter
* If self-employed, please submit Declaration Form A1
* If retired/unemployed, please submit Declaration Form A2
Family Member 3
Name: / Age: / Relationship to Applicant:
Highest Educational Level : / Marital Status:
(please delete if not applicable)
Single / Married / Divorced / Widowed / Separated / Employment Status:
(please delete if not applicable)
Employed / Self-employed / Retired / Unemployed / Housewife / Student / NSman
Job Title:
*E.g.Director, Manager, Admin Assistant, etc. / Job Sector:
*E.g. IT, Food & Beverage, Retail, etc / Name of Company/School:
*For employed/self-employed persons, indicate company’s name. For student, to indicate school/institution
Monthly Contribution (SGD):
Last Drawn Salary date*(DD/MM/YYYY):
* For salaried employee, enter amount from latest salary slip or employer's letter
* If self-employed, please submit Declaration Form A1
* If retired/unemployed, please submit Declaration Form A2
Family Member 4
Name: / Age: / Relationship to Applicant:
Highest Educational Level : / Marital Status:
(please delete if not applicable)
Single / Married / Divorced / Widowed / Separated / Employment Status:
(please delete if not applicable)
Employed / Self-employed / Retired / Unemployed / Housewife / Student / NSman
Job Title:
*E.g.Director, Manager, Admin Assistant, etc. / Job Sector:
*E.g. IT, Food & Beverage, Retail, etc / Name of Company/School:
*For employed/self-employed persons, indicate company’s name. For student, to indicate school/institution
Monthly Contribution (SGD):
Last Drawn Salary date*(DD/MM/YYYY):
* For salaried employee, enter amount from latest salary slip or employer's letter
* If self-employed, please submit Declaration Form A1
* If retired/unemployed, please submit Declaration Form A2
2.4 / Please deletewhere applicable:
a) / Are you or any of your family members listed in 2.3 (a) a bankrupt? / Yes / No
b) / Are you or any of your family members listed in 2.3 (a) suffering from any physical or mental disability? / Yes / No
c) / Are you or any of your family members listed in 2.3 (a) suffering from any terminal or critical illness? / Yes / No
d) / Do you have any siblings currently studying in a tertiary institution (e.g. Polytechnic, University)? If yes, please provide information below: / Yes / No
SIBLING(S) STUDYING IN TERTIARY INSTITUTION(S)
i) Please enter the details of your 1st sibling(if any) who is studying in antertiary institution
Name of Sibling 1:
Name of Tertiary Institution:
Country Of Institution :
Education Qualification To Be Attained:
Year Of Study:
Please indicate the sibling's source offinancing as follows:
Annual Amount(S$)
Scholarship / Yes / No
Grant/Bursary / Yes / No
Loan / Yes / No
Family Support / Yes / No
ii) Please enter the details of your 2ndsibling (if any) who is studying in antertiary institution
Name of Sibling 2:
Name of Tertiary Institution:
Country Of Institution :
Education Qualification to Be Attained:
Year Of Study:
Please indicate the sibling's source offinancing as follows:
Annual Amount(S$)
Scholarship / Yes / No
Grant/Bursary / Yes / No
Loan / Yes / No
Family Support / Yes / No
2.5 / If your family income is zero, please provide information on how your family is financially supported. [100 to 200 words]. In addition, please complete and submit Declaration Form B(Expense Worksheet)together with supporting documents.
3.OTHER FINANCIAL INFORMATION
3.1Are you or any of your family members in receipt of any form of financial assistance (e.g. from scholarships, bursaries, relatives, friends, religious organizations, part-time employment, insurance payout)? If yes, please furnish details below.
Source of Financial Assistance / Date Earned/Received
(DD/MM/YYYY) / Duration
(in Months) / Amount Earned/Received
(in SGD)
3.2Restrictions to acceptance of financial aid (Please delete where applicable)
Would you accept financial aid from a religious organization which is not of your faith? Yes/ No
3.3Are there significant medical expenses or loans? (excluding study loans and mortgages)
Please attach copies of these expenses (eg receipts for long term medical care/expenses eg surgeries etc) and loans (to members only listed in residence)
3.4Restrictions to acceptance of financial aid (Please delete where applicable)
HDB 1 ROOM FLAT / BUNGALOW
HDB 2 ROOM FLAT / SEMI-DETACHED
HDB 3 ROOM FLAT / TERRACE HOUSE
HDB 4 ROOM FLAT / PRIVATE APARTMENT (1 BEDRM UNIT)
HDB 5 ROOM FLAT / PRIVATE APARTMENT (2 BEDRM UNIT)
HDB EXECUTIVE FLAT / PRIVATE APARTMENT (3 BEDRM UNIT)
HDB EXECUTIVE CONDOMINIUM / PRIVATE APARTMENT (4 BEDRM UNIT)
HUDC FLAT
GOVERNMENT QUARTERS
WOODEN/ATTAP HOUSE
Status of financing of residence:
Fully Paid
Installment (Monthly payment (SGD): )
Rented (Monthly payment (SGD): )
4. EXTRA-CURRICULAR ACTIVITIES
4.1 Committees served or currently serving (e.g. as an office-bearer).
(a)In Junior College/High School/Polytechnics (Applicable to new students only):
Period(in Months) / Position / Name of Committee
(b)In University:
Period(in Months) / Position / Name of Committee
4.2 Sportsparticipation in Junior College/High School/Polytechnic/University
Name of Sport / Year(YYYY) / Level
4.3 Representation in talks, debates and other activities (at Junior College/High School/Polytechnic/University/National level)
Activities / Year(YYYY) / Level
4.4 Other activities at leadership level
5. DECLARATION BY APPLICANT
(1)I have read and understood the contents stated under the Section “Important Instructions and Information” in this application form.
(2)I declare that the information stated in this application and the attachments are true to the best of my knowledge and belief, and I have not willfully suppressed any material fact.
(3)I understand that any willful suppression of information will render me ineligible for consideration.
Signature:
Date:

Final instructions before you submit your application:

Please submit this application form with the Supporting Documents and Declaration Forms (where applicable).

1)Applicable supporting documents (e.g. pay slip / tax returns, etc) should be submitted with the application form. If you have previously submitted the same for AY14-15 to Office of Admissions/Financial Aid via the OFA Portal, you can omit this information. If you are unsure, please submit them again. Incomplete submissions by the deadline will render this application void and will not be considered.

2)Declaration Forms A1, A2 and B (if applicable), should be attached to the supporting documents. Submission of these declaration forms is not required if theydo not apply to you or your family member(s).

3)Staple all the documents together and mail or hand them to the Undergraduate Programs Office– Mr Louis Kong at Biz1/02-07 BBA Office by the deadline given in the email invitation.