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UPSR Academic Scholarship Application Form
SECTION B : PARENT / GUARDIAN INFORMATION ( Use Block Letters )
Name : _____________________________________________________________
I/C No : _____________________________________________________________
Birth Certificate No : _____________________________________________________________
Email Address : _____________________________________________________________
Mailing Address : ________________________________________________________________________________________________________________________
_________________________________________________________________ Postcode : _____________________________________________
Contact No : __________________________________________
Name : _____________________________________________________________
I/C No : _____________________________________________________________
Relationship : Father / Mother / Guardian
Email Address : _____________________________________________________________
Mailing Address : ________________________________________________________________________________________________________________________
_________________________________________________________________ Postcode : _____________________________________________
Contact No : __________________________________________
SECTION C : SCHOOL ATTENDED
Name of School : ________________________________________________________________________________________________________________________
Name of Principal : ________________________________________________________________________________________________________________________
Mailing Address : ________________________________________________________________________________________________________________________
_________________________________________________________________ Postcode : _____________________________________________
Contact No : _____________________________________________________________
Gender Male Female
Date Of Birth : __________________________________________
Campus : __________________________________________
Gender Male Female
Date Of Birth : __________________________________________
SECTION D : FINAL RESULTS ( Please attach certified copies of certificates )
Type of Results Actual Forecast Grade / Level of Studies : __________________________________
Recent Passport Sized Photograph
SECTION F : DECLARATION BY APPLICANT / PARENTS
I have read, understood and accept the terms & conditions. I agree to allow the School to use any photograph or any other type of material in which my child/ward/ I may appear in and/or which my child/ward / I may have
created or written, for promotion of publicity of Beaconhouse Schools I declare that the information contained in this application form and in the attached documents are true and accurate to the best of my knowledge at this time. I acknowledge that Beaconhouse Schools may seek from other relevant bodies' verification as to the standing of my child's claimed qualifications/results Beaconhouse Malaysia Sdn Bhd is bound by the Data Protection Act 2010 and information given on the Scholarship will only be used in accordance with the terms
of the Act.
Parent's/Guardian's Signature : ________________________________________ I/C No : ________________________________________
Parent's / Guardian's Name : ________________________________________ Date of Application : ________________________________________
Applicant's Signature : ________________________________________ I/C No : ________________________________________
Applicant's Name : ________________________________________ Date of Application : ________________________________________
T l 603 5632 2100 F l 603 5632 2900 E l [email protected]
Beaconhouse (Malaysia) Sdn Bhd (644050-M)Suite W1103, Wisma Consplant 1, No. 2, Jalan SS16/4, 47500 Subang Jaya, Selangor.W l www.beaconhouse.edu.my
SECTION A: PERSONAL INFORMATION ( Use Block Letters )
Grade: 7 ( IGCSE) / Secondary 1
ACADEMIC SCHOLARSHIP TERMS AND CONDITIONS
SCHOLARSHIP VALUE
ELIGIBILITY
FOR OFFICE USE ONLY
The current year's trial / forecast results are accepted. However, the Scholarship will be conditionally awarded with the forecast results until the official/actual
results are produced.
The scholarship is neither transferable nor exchangeable for cash or other alternatives.
The scholarship does not cover any registration fees and deposits which must be paid borne by the scholarship recipient
The schedule general fees must be paid as and when required accordingly and scholarship recipients are required to comply with all the rules and regulations
The scholarship cannot be offered in conjunction with any other discounts and offers at the school. At all times, applicants / students are entitled to accept one (1)
discount (or Scholarship) scheme at the school.
The scholarship is offered on tuition fees only. Students are not allowed to defer a term-unless there is extenuating circumstances approved by the Scholarship
Committee. Any cost for re-sit and re-takes must be borne by the scholarship recipient.
Scholarship recipient must complete a 2 year tenure with Beaconhouse Malaysia Sdn Bhd starting from Secondary 1 ( National Schools ) or Year 7 ( International
Schools )
In the event of any dispute on the eligibility for the scholarship, the decision made by School Scholarship Committee is final.
Successful candidates will be notified by the 30th of November 2017
Students must maintain minimum 80% average in their overall final results in every semester. Failure to maintain the average score would result in the scholarship
being withdrawn without renewal.
A parent/guardian may withdraw a student by giving a four months written notice to the school.
In the event of a withdrawal (no notice), termination, or suspension, the School reserves the right to request the scholarship recipient to reimburse Beaconhouse
Malaysia Sdn Bhd the scholarship amount she/he had been awarded.
If the withdrawal is due to medical reason, the reimbursement of the scholarship sum maybe waived at the absolute discretion of Beaconhouse Malaysia Sdn Bhd.
The scholarship recipient must submit supporting medical report from doctor(s) acceptable to Beaconhouse Malaysia Sdn Bhd for consideration.
It is compulsory for scholarship recipients to represent the school and corporate in relevant events and promotional activities as when required by Beaconhouse
Malaysia Sdn Bhd
Beaconhouse Malaysia Sdn Bhd reserves the right to involve the scholarship recipients in interviews, advertisement, photography or other publicity activities for
the purpose of promoting the School. All materials of these activities are the copyright of Beaconhouse Malaysia Sdn Bhd and can be used without prior written or
verbal permission.
Beaconhouse Malaysia Sdn Bhd reserves the right to alter, delete or add any terms and conditions of the scholarship scheme.
Beaconhouse Malaysia Sdn Bhd reserves the right to decide on the number and amount of scholarship to be awarded.
The award of the scholarship takes form of a 20% waiver on the tuition fee only for Beaconhouse National Schools;
The award of the scholarship takes form of a 25% waiver on the tuition fee only for Beaconhouse International Schools;
The scholarships are eligible for government or private school students
Students must meet the academic requirements of the following:
Ujian Penilaian Sekolah Rendah (UPSR): 6As inclusive of: English and Bahasa ( Comprehension and Writing), Mathematics and Science
The student must write a 300 word essay on the topic "The Meaning of BEACONHOUSE Motto - Seek the Light".
Open to Malaysians and International citizens.
All applications must be submitted along with the following documents to the Regional Office before the closing date 8th September 2017
Certified true copies of academic results ( forecast / actual ), 1 passport size photograph, I/C Extra Curricular certificates
Letter of recommendation from former school's principal to certify that this student has a good behavior record
Please note that the applicant will be required to attend an interview with the School Scholarship Committee.
Approved Not Approved Amount : _________________________________
Comments by the Scholarship Committee
_______________________________________________________________________________________________________________________________________
_______________________________________________________________________________________________________________________________________
_______________________________________________________________________________________________________________________________________
_______________________________________________________________________________________________________________________________________
Signature : ____________________________________________________
Name : ____________________________________________________
Date : ____________________________________________________