立 化 中学River VAlley High School
Tel: 65678115 Fax: 65677351
Email:
6 Boon Lay Avenue
Singapore649961 / 2017dsa
Application

Please read these instructions carefully.

  1. All applicantsare to ensure that the requirements for P5 Year-End and P6 Mid-Year Examination are fulfilled before applying.
  1. Applicants must fulfil the following criteriato be shortlisted for school based selection test and interview:

At least 75% for overall percentagein both P5 Year-EndandP6 Mid-Year Examinations and an “A” grade for Chinese Language inP6 Mid-Year Examination.

  1. Complete all 8 sections (Sections A, B, C, D, E, F, G and H) in the application form. Please attach additional details and/or evidence for Sections E and F ifnecessary.
  1. Submission of application: you may submit this application form and supporting documents via hardcopy or through email.If you apply through email, the original supporting documents are required for verification on the day of the interview.

a)Hardcopy submission: Submit the completed application form together with copies of the required supporting documents(See Page 8 of Application Form) to:

RIVERVALLEYHIGH SCHOOL

6Boon Lay Avenue

Singapore 649961

(Attention: 2016 DSA Application)

b)Email submission:Application forms and supporting documents may be submitted via electronic mail to. Please indicate "2017 DSA Application" in the subject field. An acknowledgement email will be sent upon receipt of application.

  1. The deadline for submission is30June 2017 (Friday), 5 pm.
  1. Please note that
  • Successful DSA-Sec students are NOT allowed to participate in the Secondary OnePosting Exercise to opt for secondary schools; and
  • Successful DSA-Sec students are alsoNOT allowed to transfer to another school after the release of the PSLE results, as students are expected to honour their commitment to the posted DSA school for the duration of the programme that he/she is admitted into.

APersonal Particulars

Name of Applicant (in BLOCK letters) Underline surname / Name in Chinese characters (if applicable) / Please affix a recent
passport-size photo
NRIC or Passport Number / Foreign Student Pass Number (if applicable)
Citizenship / Race / Religion
Date of Birth / Place of Birth / Gender (please tick)
Male
Female

BAddress & Contact Nos. of Applicant:

Name of Street : / Block:
Unit / Apartment: / Postal Code
Home Tel No / Mobile TelNo
Email address
Parent’s mobile tel no. / (please specify father/ mother)

CApplication Groups

You may apply for any of the talent areas. You may tick up to 2 boxes.

Group 1
Badminton
Basketball (Boys)
Netball
Softball
Table tennis
Volleyball (Girls)
Wushu / Group 2
Chinese Orchestra
Choir
CLDDS
ELDDS
Concert Band
Dance (Chinese) / Group 3
Info Comm
Robotics
Leadership
Group 4
Scientific Investigation
Environmental Science
Innovation
Candidates should have attained a high level of proficiency in scientific/environmental research or displayed the ability to engage in innovation or problem-solving. / Group 5
Literacy (Writing)
Communication (Speaking)
Candidates should possess strong communication skills with achievements in writingor speaking in English or Mandarin. / Group 6
Numeracy
Computer Programming
Candidates should have attained a high level of proficiency in numeracy or computational work.

Note for all applicants: Achievements at the national/international level would be an advantage. Applicants will need to attach evidence of achievement at an appropriate platform that illustrates a high level of competence.

DAcademic Results

Name of Primary School : GEP: Yes/No* (please delete accordingly)
Detailed Results / 2016Primary 5 Year-End / 2017Primary 6 Mid-Year
Overall Percentage / / 100% / / 100%
Subject / Band / Marks / Band / Marks
English Language
Higher Chinese
Chinese
Mathematics
Science

(Please attach copies of Pri5 End-Year Exam Results and Pri6 Mid-Year Exam Results.)

EAchievements In Talent Area

Please list significant achievements and contributions in your talent area.Attach additional sheets if the space provided is insufficient.

Talent / Type of Award / Year awarded / Name of awarding organisation
Evidence of talent
For sports, please specify
achievements as single, double, team player or reserve where applicable /
  • Eg. 2nd prize in Inter-School Mathematics Competition
  • Eg. Team 1st Runners-upinInter-School Badminton Competition (2nd single player for school team)
/ 2016
2017 /
  • Eg.ABCJunior College
  • Eg. XYZ Badminton Association

(Please attach copies of all relevant supporting documents.)

FCCA and Leadership

(Attach additional sheets if the space provided is insufficient.)

Areas / Year / Description
Leadership Positions in school / Eg. 2017
2016 / Eg. Head Prefect
Sectional Leader, Trumpets Section
Co-curricular Activities / Eg 2015-16
2017 / Eg. Member, Band
School Basketball Team. Participated in ….

(Please attach copies of all relevant supporting documents.)

GPersonal Statement

We want to know more about you.

立化中学是一所提供综合课程的特选中学。试以不超过200字说明你选择立化中学的理由。
In about150 words, please describe yourself, highlighting key qualities that support your application:

HDeclaration

I declare that the information provided on this application is true and complete to the best of my knowledge. Photocopies of all relevant documents are enclosed. Any false declaration will render this application invalid. The School may request for the original documents for verification.
Signature of Applicant / Date:
Signature of Parent / Guardian * / Date:
Name of Parent / Guardian *

* Please delete accordingly

Documents to be Submitted

Application Form (Duly signed by the applicant and parent / guardian)
Copies of P5 Year-End and P6 Mid-Year Examination results
Copies of other supporting documents such as CCA records, certificates, VIArecords, commendation letters or other achievements to support evidence of talent, if any.

Please note that

  • Successful DSA-Sec students are NOT allowed to participate in the Secondary One Posting Exercise to opt for secondary schools; and
  • Successful DSA-Sec students are alsoNOT allowed to transfer to another school after the release of the PSLE results, as students are expected to honour their commitment to the posted DSA school for the duration of the programme that he/she is admitted into.

1

RiverValleyHigh School6 Boon Lay AvenueSingapore649961

Tel: 65678115 Fax: 65677351 email: