Appform2011.PDF Tjz Sinchew Form

8/3/2019 Appform2011.PDF Tjz Sinchew Form

1/13

1

FullName(asshowninIC)

(CourseNo.)

Summary( ! " # $ % &

Thissummaryhastobefilledinclearlybyapplicant)

1. ' ( ) 0 1 2 3 4 5 (SPM):_________A(s),ChineseLanguageSubject:______' 6 7 8

ALevel):_________A(s)

'

(

)

0 1 9 @ 2 3 4 5

STPM)CGPA:__________/or_________A(s),ChineseLanguageSubject:______

'

A B

C D

(UEC):_________A(s),ChineseLanguageSubject:______

' E

FG

H

I P Q R S

Otheracademicqualifications:___________

2.T

U V W X Y ` a b c d

Parents/GuardiansLastYearTotalAnnualGrossIncome:_________________________

3.

e f g

hV

H

I R S

AcademicAwards/Otherachievements:

________________________________________________________________________________________________

________________________________________________________________________________________________

4. ip q r

Extra-CurricularActivities s

________________________________________________________________________________________________

_______________________________________________________________________________________________

t u

v wx y

ForOfficeUse S c

:

DateApplicationReceived:

4

(DocumentationRequired):

'Photocopyofresult:SPM/STPM/orotherequivalentcertificates:____

'LatestFormJ(IncomeTaxReturn)orEAFormorPaySliporSelf-Assessment

FormofApplicant'sparents/guardian.

'Completesetofdocumentation.

:

Recommendedforinterview:

'

(Yes)'

(No)

(Remarks):

AuthorizedsignatoryofSelectionPanel


2/13

2

\`SinChewDailyEducationFund

`ApplicationForm

P V P

(CourseAppliedFor) (CourseNo.) (NameofUniversity/College)

________________________ ________ __________________________

A.

(PersonalData)

B

FullName(asshowninIC)

j kl

HomeAddress

m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m

m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m n o

(PostCode):_______________

T

(HouseTel):m m m m m m m m m m m m m m m m m m

(HandphoneNo

m m m m m m m m m m m m m m m m m m m m m

n

(E-mailAddress

m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m

Nationality:

Race:

2

Religion:

z

NewICNo.:

{ V | V a

BirthDate:

} ~

Sex:

'

'

MaritalStatus:

'

Single'

Married

Languages

1)

1)

Written:2)Spoken: 2)

(EducationalQualifications)

Recent

Photograph(1copy)

u

-

x

Thisscholarshipawardisnotcashawardbutwillbeintheformofacademiccoursestobeofferedbytheparticipatingcolleges/institutionsofhigherlearning/universitieswiththetuitionfeesand/or

suchotherincidentalexpensesfullypaidup.

'

'

'

'

'


3/13

3

SPMP k

l

NameandAddressofSchool:

D

a

YearTaken:

ALevelP k

l


D

a

YearTaken:

@

OverallGrade:

b P

Aggregate:

Subject

@

Grade

Subject

@

Grade

Subject

@

Grade

Subject

@

Grade


4/13

4

P kl


D

a

YearTaken:

b P

Aggregate:

! " # $

UECP k

l


D a

YearTaken:

b P

Aggregate:

Subject

@

Grade

Subject

@

Grade

Subject

@

Grade

Subject

@

Grade


5/13

5

C.% &

'

(

)

0

AcademicAwards/OtherQualifications

Date

D

V

g

h

NameofExamination/Award

V

g

Grade/Award

1

2 3 4

Extra-CurricularActivities

5

F 6

7 V P8

Associations/ Societiesa

Year9

@

Position

E.A

B C D

WorkExperiences

E F G V kl

(NameandAddressofEmployer)9

@

(Designation) H

(Period)


6/13

6

F.I P

Q R

(HealthCondition)

S T U V

W X Y `

E a b c

YV

d ef g h

(Pleasestatepresenthealthcondition,detailsofanyillness,disabilityorincapacity.)

G.i

pq r

(Reason(s)forApplication)

sg

t u v

(Yourreason(s)forthisscholarshipapplication.)


7/13

7

H.w

x y

DetailsofFamilyBackground

(Father)

(Mother)

Name

B

B

z

ICNo.

a

Age:

a

Age:

T

kl

HomeAddressm m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m

m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m

n o

(PostCode):_________________

(Tel):____________________

(Handphone):____________________

m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m


n o

(PostCode):m m m m m m m m m m m m m m m m

(Tel):____________________

(Handphone):m m m m m m m m m m m m m m m m m m m m

9

Occupation:E F

Nameof

EmployerE F k

l

Addressof

Employerm m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m

m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m

n o

(PostCode):m m m m m m m m m m m m m m m m m

(Tel)

m m m m m m m m m m m m m m m m m m m m

:m m m m m m m m m m m m m m m m m m m m



n o

(PostCode):m m m m m m m m m m m m m m m m

(Tel)


____________________

I.

Guardian

Name

B

z

ICNo.

a

6

9

Occupation

T

kl

Home

Addressm m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m

m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m m n o

(PostCode):m m m m m m m m m m m m m m m m m

(Tel)


(Handphone):m m m m m m m m m m m m m m m m m m m m


8/13

8

w

p

u

(DetailsofParents/GuardiansOwnBusiness):j k

V { l kl

NameandAddressofBusiness

m

n

:

{ l } o

BusinessNature:

X

EstablishmentofBusiness

m m m m m m m

a

(years)

m m m m m m

|

(months)

{ l

X

'

'

Isthebusinesswhollyowned?

W z Y{ | }

sg

T

U V W X Y ~

X

Pleasestateshareheldbyparents/guardian,ifinpartnershiporjointventure.

w

Parents/GuardiansLastYearAnnualGrossIncome

Father

Mother

W X Y

Guardian

b

Total E

Asemployee

{ l

OwnBusiness

RentalIncomeH

I

Othersb

Total

w

x

ExpendituresofFamily:

h

Items

|

Monthly(RM)

a

Yearly(RM)

V

HouseInstallments/Rental

(

/

/

H

I

)LoanRepayment(motorvehicles/appliances,etc...)

7

V

Electricity/Water/Telephone2 3

m m m m m

@

Educationfor____childrenH

I

Othersexpensesb

Total


9/13

9

w

NamesandParticularsofSiblings/OtherDependents

Name

Relations

a

Age

MaritalStatus

9

Occupation

a c d

(RM)

AnnualIncome

B

B

B

B

B

B

J -

Referees

Name

B

Name

B

kl

Address

(Tel):

kl

Address

(Tel):9

Occupation

9

Occupation


10/13

10

p

ThefollowingdocumentsmustbesubmittedtogetherwiththeApplicationForm:

e g P ' X (Yes) ' (No)Haveyoubeenawardedanyscholarshipbefore?

X}

R

s

IfYes,pleasesupplythefollowinginformation:

a

Year

P V P

University/College

Course

g

P @

Sponsorshipunit

e

H

I

2 3

'

X

(Yes)'

(No)

Hasanyofyoursiblings(brother(s)/sister(s))benefitedfromothereducationfunds?

X}

%

R

Ifapplicable,pleasesupplythefollowinginformation:-

Name

Relationship

Course

P

College

d P a

Year

Admitted

e

g

P

'

X

(Yes)'

(No)

Hasanyofyoursiblings(brother(s)/sister(s))appliedtothisFund?

1. IdentityCard(bothsides)

2. { Birthcertificate

3.(

)

0 1 2 3 4 5

V

(

)

0 1 9 @

P

4 5

V

A B

C D

V

H

I

R S D

4 5

SPM/STPM/UEC/Otherequivalentqualifications.

4. i p q r Testimonial(s)andrecord(s)ofparticipationinextra-curricularactivities

5. T U V W X Y g 4 s c d c V V S V U

|

7

V

7

H

I

4

Photocopiesoflatestsupportingdocument(s)onthefinancialstatusofApplicantsparents/guardians:LatestForm

J(IncomeTaxReturn)/EAForm/Self-AssessmentForm/last3monthsofthesalaryslips/utilitiesbillsandother

documents


11/13

11

f

: 7

6

d e S

/g

B

h

Recital:SinChewMediaCorporationBerhadshallhereinafterbereferredtoastheSCMCB.

%

S

V

h

Youarerequiredtoreadtheprocedures,requirements,termsandconditionshereinbelowcarefullybeforesubmittingyourapplication.

i

p

Procedures:

X

g! "

E

# h

R

E

l R

V

h 4

! "

h

)

h X

! " d !

V "d #

$

f g % &

h

Pleasenotethatanyfalseparticulars,information,documents,untruthfulmaterialfactsormisrepresentationswillsubject

youtodisqualification.Theapplicationformshouldbeprintedoutclearlyorbewrittenlegiblyandmustbeaccompaniedby

therequireddocumentsandmustbesubmittedbeforethepublishedclosingdate.Proofofpostingisnotproofofreceipt.Theselectedcourse(s)mustbeclearlywrittenorprintedonthetoplefthandcorneroftheenvelope.TheSinChewDaily

EducationFundsaddressisasfollows:

2 3

SinChewDailyEducationFund

SinChewMediaCorporationBerhad(SCMCB)19JlnSemangat

46200PetalingJaya

SelangorDarulEhsan

f

n '

5

( )

4

c

(

h

(Pleasenotethatproofofpostingisnotproofofreceipt.)

i

p0 1

:

TermsandConditions:

! " 2

{

Thefollowingtermsandconditionsshallapplytoallapplications:-

1.3

2011a

1|

1 4

V5 d

266

(

)0 1 j 7 h

TheapplicantmustbeaMalaysiancitizenbelow26yearsofageasat1st

January2011.

2. d ( ) 0 1 2 3 4 5 /A7 8 V ( ) 0 1 9 @ P 4 5 V A B C D E H I D B D f 8 9 h StudentsmustpossessgoodresultsinSPM/A-Level/STPM/UECorotherequivalentqualifications.

3. q @ A r i

p q rh

Studentsmustbeactiveinsportsandextra-curricularactivities.

4.B

X

V

C D

a b

P

E

E

F

/g

P h

Studentsmustnotbebondedorinreceiptofanyfinancialaidorrewardsfromothereducationalorganisationsor

institutions.

5. d }g

P d % ! "

G

4 5

h

Theapplicantsmustproduceoriginalcopiesoftheexaminationresultsandallotherrelevantdocumentsduringthe

interview.

H I P Q R

SPMS T U V W X Y

14

a b c

d

e fg h i p

X q r s

t u vf

w x

Applicationdeadline:14thdayafterthe

announcementofSPMResult.Ifnot,pleasereferto

ourSinChewDailyforthelatestdeadline.


12/13

12

6.y

j

Theselectioncommitteesdecisioninallmatterspertainingtotheselectionofthescholarshipawardisfinalandno

appeal,inquiryorcorrespondencewillbeentertained.

k l m n o m m z { | } ~ m jStudentsmustmeettheminimumrequirementsetbytheColleges/Universitiesinordertobequalifiedforselection.

l m m m } ~ m m j

Differentcolleges,universitiesandcourseshavedifferententryrequirements.Pleaseliasedirectlywiththecollegesor

universitiesconcernedformoredetails.

9.m n

m m

-

-

j TherecipientisnottodiscontinueorswitchCourseortotakeupanyfullorparttimeemploymentwhilepursuingthe

saidCoursewithoutthepriorwrittenapprovalofSCMCBorTheCollege/UniversityconcernedunlesssuchemploymentispartandparcelorrelatedtothesaidCourse

10. m n m m

j

Therecipientisnotallowedtoparticipateinanyformofillegalactivityorjoinanyunlawfulorganisationswhichinthe

opinionofSCMCBorTheCollege/Universitywouldembarrassorcausedisreputetoallpartiesconcernedthroughoutthestudyperiod.

11. m n o { n

j

Therecipientistoattendallclasses,lectures,tutorialsandlessonsasrequiredbythesaidCourseregularlyand

diligentlyunlessheorsheismedicallyunfittodoso.

12. m n o m m jTherecipientisrequiredtoobeyallrulesandregulationsoftheparticipatingCollege/Universityatalltimeandis

expectedtoconducthimself/herselfinarespectablemanner.

13. m

m

m n

o

m

j

TheparticipatingCollege/UniversityandSCMCBarenotobligatedtoextendtheawardbeyondtheexisting

academicperiod.

14. j j SCMCBreservetheirrighttoaddoramendtherulesandregulationscontainedhereinwithoutpriornotice.No

complaintwhatsoevershallbeentertained.

15. m j / m /

m

m

j

m n

o

o

m

! " # $ %

j

TheawardsarenotdirectlyofferedbySCMCBbutareofferedbytheparticipatingeducationalinstitutionsorother

sponsorsthroughSCMCBandtherecipientmayberequiredtosignabonddirectlywiththeparticipatingColleges/

Universitiesifrequiredtodoso.


13/13

13

& ' ( ) 0 1

APPLICANTSDECLARATION

2

3 4 5 6 7 8 9 @ A B C D E F G H I P Q R S T A U V W X Y 9 ` a b c B d e f g h i p q r @ s t u v h w x y B

4 5

P

5

@

G P

B

@

4 5 j k

G l mb

n

3 4 5 o 8 @ 6 G T k z @ { | } s t u v h w x y ~ g G | k P

b

3 4 5 @ c G w x y @ h w x y G z 5h

@

d e

@ B h h B d e q G -

@w

x y

E d e

db

4 5

P

P

5

w

x y

d e

G

b

3 4 5

E G

@ s t u

v G o

5

h d e o 8 @

P

d e o

8

b

3 4 5 8 9 A B @ 4 b

3 B c w x y G P h

B

b

3 c 4 T G H 4 E G H 4 G s 4 G b

1. Ideclarethattheinformationgivenhereinaretrueandaccuratetothebestofmyknowledgeandbelief.Ifatanytimehereaftersuchinformationarefoundtobeuntrueorfalseormisleadingduetowillfulneglect,SCMCBshallbeatlibertytotakeactionsagainst

me,includingthewithdrawalofanybenefitalreadygrantedtomeandtherecoveryofalllossessustainedbySCMCBorsuch

furtheractionsdeemfitandproperbySCMCB.

2. IagreethattheawardisnotadirectgrantofSCMCBbutisgrantedbytheparticipatingColleges/UniversitiesthroughSCMCBandassuchanyfailuretohonorthescholarshipawardbywayofdiscontinuance,termination,suspensionorvariationbythecollege

ortheuniversityconcernedshallnotbethefaultorliabilityofSCMCBandIagreethatnolegalactionswhatsoevershallbetaken

againstSCMCBbymeand/ormyparentsorguardian(s).

3. IagreetocompletethecourseofstudywithinthestipulatedtimeandtofurnishmyprogressreportsorexaminationresultsasmayberequestedbySCMCBfromtimetotime.

4. IunderstandthatImayberequiredtosignabonddocumentortoprovidesecurityorsuretypriortotheawardofthesaidscholarship.

5. Iconfirm,acceptandagreetobeboundbyallthetermsandconditionsasstatedinthisapplication.

6. IfurtherdeclarethatIamfullyawarethatthescholarshipaward,ifgrantedbySCMCB,willnotbeintheformofcashawardbutwillbeintheformofacademiccoursestobeofferedbytheparticipatingcollegesand/orinstitutionsofhigherlearningwiththe

tuitionfeesand/orsuchotherincidentalexpensesincluded.

7. IagreethatintheeventofconflictbetweentheChineseandEnglishversionsasstatedinthisapplication,theEnglishversionshallprevailandshallbetheprincipalandprimarytextofinterpretation.

NameofApplicant__________________________ I/CNo ________________________________"

SignatureofApplicant_________________________Date _______________________

Documents

Appform2011.PDF Tjz Sinchew Form