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March 2020 MOSQUE - BASED KINDERGARTEN 1
AL-ISTIQAMAH MOSQUE KINDERGARTEN ENROLMENT FORM
(Private and Confidential) INSTRUCTIONS & FOR OFFICIAL USE
INSTRUCTIONS:
1. All clauses must be read and understood.
2. All questions and sections in this form MUST be answered.
3. Any incomplete registration forms will be rejected.
4. Statement of Declaration must be acknowledged and signed.
5. Relevant documents listed below must be provided at the point of registration.
6. Copies of all required documents must be submitted before the enrolment date.
(Please put a tick ✓ in the box when you have attached the document or state ‘NA’ if not applicable)
✓ DOCUMENTS SUBMISSION (COPIES)
Child's Birth Certificate (S’porean / PR) *FIN / Passport (PP) (Foreigner)
Child's Health Booklet (for birth order, developmental & immunization records / certificate)
NRIC of Main Applicant (S’porean / PR) *FIN / Passport (PP) (Foreigner)
NRIC of Spouse of Main Applicant (S’porean / PR) *FIN / Passport (PP) (Foreigner)
CDA statement of account (if use CDA for fees) Sibling’s Birth Certificate (if use sibling’s CDA)
Marriage Certificate of latest marriage Letter of Authorization (for Guardianship)
Letter from lawyer firm if in process of divorce Statutory Declaration of Marital Status
Divorce & Custody Papers with clause stating who has ‘care & control’ of child from previous marriage
Certification of Death of Spouse
✓ PHOTOGRAPH SUBMISSION ✓ REQUESTS
Child My child will need the school transport.
Main Applicant My child is a foreigner without a Dependant Pass and will need to apply for a Student Pass.
An approved Student Pass will be required before admission to the Kindergarten.
Spouse of Main Applicant
Emergency Contact(s) My family needs Financial Assistance
To refer to SDO (Social Development Officer)
Authorized Person(s) picking up child Others, please specify:
FOR OFFICIAL USE ONLY REGISTRATION FEE (non-refundable)
$ TOTAL FEE PAID
SCHOOL FEE (DEC 2021) $ PAID BY CASH / NETS / CDA NETS (delete where applicable)
INSURANCE $3.00
RECEIPT NO. NAME OF OFFICER & DATE:
YEAR : 2021 Name of Child:
__________________
__________________
__________________
__________________
Class: ____________
March 2020 MOSQUE-BASED KINDERGARTEN 2
AL-ISTIQAMAH MOSQUE KINDERGARTEN
ENROLMENT FORM (Private and Confidential)
CLASS DETAILS
LEVEL (PLEASE TICK)
PN (3 YRS OLD)
N1 (4 YRS OLD)
K1 (5 YRS OLD)
K2 (6 YRS OLD)
SESSION & TIMING (Please TICK)
CLASS NAME SESSION / DAY MONDAY TO THURSDAY FRIDAY
SESSION 1 8am to 12pm 8am to 10am
SESSION 2 1pm to 5pm 10am to 12pm
PART 1. CHILD’S PARTICULARS
Name: __________________________________________________________________________________________
Date of Birth: __ __ __ __ __ __ __ __ Gender: *Male / Female day month year
Type of Citizenship: Singaporean Singapore PR Foreigner
Identity Type : Singaporean/PR: BC Foreigner: FIN Passport
Identification Number: ________________________________________________________
Race: Malay Chinese Indian Others: _____________________
Class of Licence: C Level: PN N K1 K2
Type of Service: Session 1 2 Program Fee (Full Month Fee): ________________________
Total no. of children in family: ______________________ Birth Order: ______________________________
Child living with: Father Mother Siblings Guardian
Has the child attended OR is attending other schools? * Yes / No
Name of School : ______________________________________________________________________________
Any siblings currently OR had enrolled in this Kindergarten? * Yes / No
Or other Mosque Based Kindergarten? Please specify:______________________________________________
Name of Sibling(s) & (Age) : ____________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
2021 Date of Enrolment:
________________________
March 2020 MOSQUE-BASED KINDERGARTEN 3
PART 2. APPLICANTS’ PARTICULARS
MAIN APPLICANT
Relationship to Child: * Mother / Father / Guardian Relationship to Child: * Mother / Father / Guardian
Type of Citizenship: Singaporean PR Foreigner Type of Citizenship: Singaporean PR Foreigner
Identity Type: Singaporean or PR: NRIC
Foreigner: FIN Passport
Identity Number: ________________________________
Identity Type: Singaporean or PR: NRIC
Foreigner: FIN Passport
Identity Number: ________________________________
Name: Name:
Date of Birth: __ __ __ __ __ __ __ __ Day month year
Date of Birth: __ __ __ __ __ __ __ __ Day month year
Gender: * Male / Female Gender: * Male / Female
MARITAL STATUS
*Single / Married / Separated / Divorced / Widowed
MARITAL STATUS
*Single / Married / Separated / Divorced / Widowed
CONTACT NO: ___________________________(Mobile)
________________(Home) _________________(Office)
CONTACT NO: ___________________________(Mobile)
________________(Home) _________________(Office)
Email Address: Email Address:
Address: (As stated in NRIC / FIN)
Postal Code: ______________ Blk/House No.: _______
Street Name: __________________________________
Unit No.: _______ Floor No.: ____
Building Name: _________________________________
Address (If different from main applicant)
Postal Code: ______________ Blk/House No.: _______
Street Name: __________________________________
Unit No.: _______ Floor No.: ____
Building Name: _________________________________
HIGHEST EDUCATION LEVEL
No Formal Education Primary Secondary Junior College / Pre-U Polytechnic Diploma Bachelor’s Degree Postgraduate Qualifications (___________________) Others: _____________________________________
HIGHEST EDUCATION LEVEL
No Formal Education Primary Secondary Junior College / Pre-U Polytechnic Diploma Bachelor’s Degree Postgraduate Qualifications (___________________) Others: _____________________________________
OCCUPATION: OCCUPATION:
SALARY: _____________(GROSS)_____________ (NETT) SALARY: _____________(GROSS)_____________ (NETT)
PART 3. HOUSEHOLD PARTICULARS
MONTHLY GROSS HOUSEHOLD INCOME: _______________ NUMBER OF PEOPLE IN THE HOUSEHOLD: __________
HOUSING TYPE:
HDB: * Rental / Purchased / Others 1 room 2 room 3 room 4 room 5 room Executive
OTHERS: Condominium Private Apartment Landed Property
SPOUSE OF MAIN APPLICANT
March 2020 MOSQUE-BASED KINDERGARTEN 4
PART 4. GETTING TO KNOW YOUR CHILDWhat is the language spoken by your child at home?
Most Frequent: _________________________________ Less Frequent: ___________________________________
Favourite Colour: _____________________________ Favourite Food: _________________________________
How long does your child watches TV at home? _______________hrs daily.
How long does your child use an electronic device daily? ____________hrs daily.
* Computer / IPad / Kinect / Smartphone / Tablet / Wii console / XBOX / Others: _________________________
How often does your child go outdoors to play? ____________________________________________________
Tell us more about your child:
My child likes _______________________________________________________________________________
My child does not like ________________________________________________________________________
Any other comments about your child
___________________________________________________________________________________________
PART 5. HEALTH INFORMATION
Has your child received the COMPULSORY immunization by law? (Diphtheria and Measles) * Yes / No
If no, please provide reasons / details: _________________________________________________________
Does your child have any of these medical conditions?
Asthma# *Bone / Joint Injury Diabetes Eczema HIV Hepatitis B Heart problems *Fits / Epilepsy / Fainting spells
Others: _______________________________________
#Asthma: If necessary, will child need to use an inhaler in school?* Yes / No
Any Medical or Food Allergy:
______________________________________________
______________________________________________
Does your child have any areas of Special Needs?
Autism Spectrum Disorder (ASD) Attention Deficit and Hyperactivity Disorder (ADHD) Down Syndrome Global Development Delay (GDD) Physical Disability (Specify: _____________________) *Speech Impairment / Undergoing Speech therapy
Others or any suspicion, please specify:
_______________________________________________
_______________________________________________
Any letter from Doctor / Qualified Practitioner that certify / diagnosed Medical condition or Special Need? * Yes / No
Any Allergy Action Plan issued by a Doctor? *Yes / No. If necessary, will child need to use an Epi-Pen? * Yes / No
Name of Family Doctor (if any) ___________________________________________ Tel: _____________________
Name of Family Clinic & Address:
______________________________________________________________________________________________
March 2020 MOSQUE-BASED KINDERGARTEN 5
PART 6. SCHEDULE OF PAYMENT
Please make the payment of the registration fee and ONE(1) month fee (December 2021) upon registration.
Subsequently, all fees will be deducted on the next scheduled GIRO deduction date.
Please note that public and school holidays are included in the computation of fees. The fee for Kiddie-Fitness On Wheels gym enrichment programme is inclusive in the monthly school fee.
Please note the following:
1. The registration fee is non-refundable and non-transferable.
2. Insurance coverage is inclusive in the school fee.
We would also like to highlight that there will be annual fee revision. You will be informed well ahead of time of any change to the fees.
MODE OF PAYMENT
We arrange for payment to be made by GIRO/CDA. GIRO/CDA deductions will be made on the (1st and 16th) of every month. Payment of fees must be made by the (15th) of every month if paying by CASH.
NON-PAYMENT OF FEES
We strongly encourage you to pay your child’s fees on time. Reminders will be given for fees not paid. We would appreciate that you adhere to the payment schedule to avoid disruption of services rendered. Non-payment of school fees for 2 consecutive months will subsequently result in the suspension of your child to attend the school.
WITHDRAWALS
If you wish to withdraw your child, please ensure that:
1. You complete and submit the official Withdrawal Form to the Kindergarten Principal giving at least 30days' notice (including Saturdays & Sundays), prior to the last day of attendance.
2. Withdrawals will only take place on the last day of the month.
Please note the following:
1. The December school fee is refundable upon withdrawal and only if the Kindergarten is officially given30 days' notice in writing, failing which it will be forfeited.
2. The December school fee will be refunded after the payment of the last month's fees.
3. Children cannot be placed on temporary withdrawal during the notice period.
4. Kindergarten will strictly not accept temporary withdrawal of children.
March 2020 MOSQUE-BASED KINDERGARTEN 6
PART 7. CDA (BABY BONUS)DO YOU KNOW YOU CAN USE YOUR CHILD’S CDA ACCOUNT TO PAY?
The Kindergarten is an Approved Institution registered with MSF under the Baby Bonus Scheme.
You can use the savings in the CDA account to pay fees for all your children who are enrolled in our Kindergarten. The type of Kindergarten fees payable by the CDA are:
You can also use the CDA card to make the payment using the NETS terminal at the Kindergarten.
Please complete the CDA GIRO application form for fees to be deducted from your CDA account for payment of the monthly fees. If using a sibling’s CDA, please submit a copy of the Birth Certificate.
Note: CDA cannot be used for aLIVE Madrasah & enrichment class fees.
PART 8. DECLARATIONS (KINDERGARTEN’S COPY)( Note to Kindergarten Staff: Ensure the parent / guardian understand each declaration term and )
1. Authorization for Pick-up of Child I agree to allow the Kindergarten to release my child to the list of authorized contact persons as stated in this application form. I understand that the authorized persons to fetch my child must be 16 years old or older. Otherwise, a letter of authorization from me must be submitted. I also agree that in the event that any of the authorized persons are unable to fetch my child, I will arrange for an alternative person and will inform the Kindergarten at least 1 day in advance. Necessary forms and procedures will be adhered as part of the authorization process.
2. Kindergarten Activities I agree for my child to participate in all indoor and outdoor activities conducted by the Kindergarten during the period that my child attends the Kindergarten.
3. Emergency Medical Care In the case of any emergency, I agree in the event that, if I or the people I authorize for an emergency cannot be reached in a timely manner, that an official representative of the Kindergarten seek first aid or emergency medical care for my child. I further give my consent for an emergency medical facility or physician to administer necessary medical treatment to my child if I am unable to be reached or the situation requires immediate attention. I understand that I am responsible for paying all medical bills.
4. Infectious Diseases I understand that common infectious childhood diseases, including but not limited to Hand, Foot and Mouth Disease (HFMD) and chickenpox, are present throughout the year in Singapore and can be easily spread amongst children in Kindergartens. I agree to keep my child away from the Kindergarten until after the expiry of the medical leave.
I also agree that the Kindergarten will not be held liable for any infectious diseases that my child contracts at the Kindergarten. There will be no obligation whatsoever by the Kindergarten to refund or waive fees for the period that my child is away from the Kindergarten due to illness or due to fear of contracting an illness.
5. Inappropriate Behaviour & Mutual Trust and Agreement I understand that the Kindergarten is a peaceful and safe place for children, teachers, staff and families. Abusive behavior, both physical, verbal or written is not tolerated. I also agree that abusive behaviour on the part of myself or my family members are not tolerated. As our teachers and staff play an integral part in the day to day operations of the Kindergarten, we hope that you uphold the same level of respect that they have uphold towards you.
1. Registration fee
2. Monthly school fee
3. Termly material fee
4. Advance December fee
5.
March 2020 MOSQUE-BASED KINDERGARTEN 7
6. PDPA (Personal Data Protection Act) I hereby understand and agree that the Kindergarten has the right to collect my personal data to be used for the administrative, finance and operation process of my child’s registration as well as for programme planning and delivery. I understand that all data will be safely kept according to the Kindergarten’s internal policies and procedures.
7. Photograph / Video of Child – Consent of Use I agree to photographs/videos taken of my child to be used for purposes pertaining to the Kindergarten or my child's participation in Kindergarten activities or for publicity purposes which may include means of media such as print or digital.
8. Special Needs Concern
If your child has any medical condition stated, please submit a medical report from a certified practitioner
to the Kindergarten to certify that your child is able to participate in activities conducted at the Kindergarten.
As we have designed our daily program to mainly cater to the needs of a typically developed child, the
needs of a special need child may not be fully met in our programme.
Therefore, we request that parents inform the Kindergarten, at the time of registration, if your child has been diagnosed as having special needs or if you have any concerns regarding your child’s learning and behavioural development.
8A. Diagnosed with Special Needs
If your child has been diagnosed as having special needs, enrolment into our Kindergarten will be subjected to
the following terms:
1. The extent of your child’s special needs are mild and your child does not require one to one or individual
adult/child attention to participate in the daily activities of the Kindergarten.
2. Your child continues to receive necessary support and intervention programme (e.g. physiotherapy, speech
therapy, EIPIC etc.). Parents are to update the Kindergarten of any updates or reports by the intervention
programmes.
3. Enrolment will be on a trial period of 1 month and is subjected to review by the Kindergarten.
8B. Undiagnosed with Special Needs before Enrolment
If your child has been enrolled and is observed by the teachers to consistently demonstrate behaviours that are not within the norm of the typically developing child, the Kindergarten Principal will advise you to seek
professional assessment.
The Kindergarten Principal will provide a referral letter for you to seek a doctor’s recommendation and you will have to proceed with the necessary follow-ups.
Your co-operation in seeking professional assessment within an agreed period is crucial in supporting your
child. You are also required to inform the Kindergarten about the details of your visit and the results of the
diagnosis or intervention plans.
If your child is found to have special needs and requires special help and attention which the Kindergarten
cannot provide, then parents will have to withdraw the child for enrolment in a Special Needs school or
programme that caters specifically to the needs of their child.
If the child's special needs are manageable by our Kindergarten staff and we are confident that the child can
benefit from the Kindergarten's programme without special help or individual adult-to-child attention, then
the child may continue to be enrolled in the Kindergarten subject to 3-monthly review and provided the child
continues to receive the required special help from support services agency, e.g. physiotherapy, speech
therapy, social skills training, etc.
March 2020 MOSQUE-BASED KINDERGARTEN 8
PART 9. STATEMENT OF DECLARATION
I declare that the information provided in this application is true and has been provided willingly.
I understand that any part of this application improperly completed or falsely declared may lead to rejection of the application.
I agree to immediately inform the Kindergarten of the following:
1. Updated medical report of my child or any illnesses that my child might suffer from subsequently upon completion of this application.
2. Changes in the particulars of the authorized caregiver(s) in relation to this application
I *would like / would not like to apply for the *CDA GIRO / BANK GIRO scheme to pay for my child’s fees.
I agree to abide and be bound by all terms, conditions, rules and regulations of the Kindergarten.
The contents of this declaration have been read and explained to me and I fully understand its meaning.
______________________________________________ ___________________________________________ Signature ( Main Applicant ) Signature ( Spouse of Main Applicant )
______________________________ Date
PART 10. FOR OFFICIAL USE ONLY Please fill in the details of the staff that had gone through this form with the applicant.
NAME OF STAFF : ______________________________________________________________________________________
SIGNATURE & DATE: ____________________________________________________________________________
DESIGNATION: _________________________________________________________________________________
mo
AL-ISTIQAMAH MOSQUE KINDERGARTEN
PHOTOGRAPHS & PARTICULARS of CHILD, APPLICANTS & EMERGENCY CONTACTS
Paste
Child’s recent Photo
here
Name of Child: _______________________________________________________ Date of Birth: _______________________________ (DD/MM/YYYY) Year / Class: _________________________________________________________ BC /PP/ FIN: _________________________ Enrolment Date: __________________ Address: ____________________________________________________________ ____________________________________________________________
Paste Main Applicant’s
recent Photo here
Name of Main Applicant: ______________________________________________ NRIC/PP/FIN: ______________________ Relationship to child: ________________ Home Tel: _______________________ Office Tel: __________________________ Mobile: __________________ Email: ____________________________________
Paste Spouse of Main Applicant’s
recent Photo here
Name of Spouse of Main Applicant: ______________________________________ NRIC/PP/FIN: ______________________ Relationship to child: ________________ Home Tel: _______________________ Office Tel: __________________________ Mobile: __________________ Email: ____________________________________
Paste Emergency Contact
Person’s recent Photo
here
Contact Person in case of Emergency: ____________________________________ (Other than the main applicant or spouse of main applicant)
Relationship to Child: _________________________________________________ NRIC/PP/FIN: ________________________ Home Tel: _______________________ Mobile: _________________________ Office Tel: _________________________
Paste Emergency Contact
Person’s recent Photo
here
Contact Person in case of Emergency: ____________________________________ (Other than the main applicant or spouse of main applicant)
Relationship to Child: _________________________________________________ NRIC/PP/FIN: ________________________ Home Tel: _______________________ Mobile: _________________________ Office Tel: _________________________
mo
AL-ISTIQAMAH MOSQUE KINDERGARTEN
PHOTOGRAPHS & PARTICULARS of AUTHORIZED PERSONS TO FETCH CHILD *Authorized person to fetch child must be 16 years old & above.
Otherwise, letter of authorization from main applicant must be submitted.
Name of Child: _____________________________________________________________________________
Year / Class:
Paste Authorized Person
to Fetch recent Photo
here
Authorized Person to Fetch: ___________________________________________ (Other than the main applicant or spouse of main applicant)
Relationship to Child: __________________________________________________
NRIC/PP/FIN: ________________________ Home Tel: _______________________
Mobile: __________________________ Office Tel: _________________________
Paste Authorized Person
to Fetch recent Photo
here
Authorized Person to Fetch: ___________________________________________ (Other than the main applicant or spouse of main applicant)
Relationship to Child: _________________________________________________
NRIC/PP/FIN: ________________________ Home Tel: _______________________
Mobile: __________________________ Office Tel: _________________________
Paste Authorized Person
to Fetch recent Photo
here
Authorized Person to Fetch: ___________________________________________ (Other than the main applicant or spouse of main applicant)
Relationship to Child: _________________________________________________
NRIC/PP/FIN: ________________________ Home Tel: _______________________
Mobile: __________________________ Office Tel: _________________________
Paste Authorized Person
to Fetch recent Photo
here
Authorized Person to Fetch: ___________________________________________ (Other than the main applicant or spouse of main applicant)
Relationship to Child: _________________________________________________
NRIC /PP/ FIN: ________________________ Home Tel: ______________________
Mobile: _________________________ Office Tel: _________________________
Paste Authorized Person
to Fetch Photo here
Authorized Person to Fetch: ___________________________________________ (Other than the main applicant or spouse of main applicant)
Relationship to Child: _________________________________________________
NRIC/PP/FIN: ________________________ Home Tel: _______________________
Mobile: __________________________ Office Tel: _________________________
Name of Child 1: Name of Child 2: 1: 2: Identification Number: undefined: Program Fee Full Month Fee: Total no of children in family: Birth Order: Name of School: Or other Mosque Based Kindergarten Please specify: Name of Siblings Age 1: Name of Siblings Age 2: Name of Siblings Age 3: Identity Number: Identity Number_2: Name_2: CONTACT NO 1: CONTACT NO 2: Home: CONTACT NO 1_2: CONTACT NO 2_2: Home_2: Email Address: Email Address_2: Postal Code: BlkHouse No: Postal Code_2: BlkHouse No_2: Street Name: Street Name_2: Unit No: Floor No: Unit No_2: Floor No_2: Building Name: Building Name_2: Postgraduate Qualifications: Postgraduate Qualifications_2: Others: Others_2: OCCUPATION: OCCUPATION_2: SALARY: GROSS: SALARY_2: GROSS_2: MONTHLY GROSS HOUSEHOLD INCOME: NUMBER OF PEOPLE IN THE HOUSEHOLD: Less Frequent: undefined_2: undefined_3: undefined_4: How long does your child watches TV at home hrs daily: How long does your child use an electronic device daily: Computer IPad Kinect Smartphone Tablet Wii console XBOX Others: How often does your child go outdoors to play: My child likes: My child does not like: Any other comments about your child: If no please provide reasons details: Others_3: Others or any suspicion please specify 1: Others or any suspicion please specify 2: Any Medical or Food Allergy 1: Any Medical or Food Allergy 2: Name of Family Doctor if any: Tel: Name of Family Clinic Address: BC PP FIN 2: Address: Name of Child: Enrolment Date: undefined_5: Relationship to child: Email: Office Tel: Relationship to child_2: Email_2: Office Tel_2: Relationship to Child: Contact Person in case of Emergency: Office Tel_3: Relationship to Child_2: Contact Person in case of Emergency_2: Office Tel_4: Name of Child_2: Authorized Person to Fetch: Relationship to Child_3: Home Tel_3: Office Tel_5: Authorized Person to Fetch_2: Relationship to Child_4: Home Tel_4: Office Tel_6: Authorized Person to Fetch_3: Relationship to Child_5: Home Tel_5: Office Tel_7: Authorized Person to Fetch_4: Relationship to Child_6: NRIC PP FIN: Home Tel_6: Office Tel_8: Authorized Person to Fetch_5: Relationship to Child_7: Home Tel_7: Office Tel_9: Others please specify: Check Box1: OffCheck Box2: OffCheck Box3: OffCheck Box4: OffCheck Box5: OffCheck Box6: OffCheck Box7: OffCheck Box8: OffCheck Box9: OffCheck Box15: OffDropdown2: [FIN]Check Box10: OffDropdown1: [FIN]Check Box11: OffDropdown4: [FIN]Check Box12: OffCheck Box13: OffCheck Box14: OffCheck Box23: OffCheck Box25: OffCheck Box27: OffCheck Box28: OffCheck Box29: OffCheck Box24: OffCheck Box30: OffCheck Box31: OffCheck Box32: OffCheck Box33: OffCheck Box34: OffCheck Box35: OffCheck Box36: OffCheck Box41: OffCheck Box60: OffName: Dropdown8: [01]Dropdown9: [01]Dropdown10: [2018]Dropdown3: [MALE]Check Box42: OffCheck Box17: OffCheck Box37: OffCheck Box38: OffCheck Box39: OffCheck Box40: OffCheck Box18: OffCheck Box19: OffCheck Box20: OffCheck Box21: OffCheck Box56: OffCheck Box46: OffCheck Box43: OffCheck Box44: OffCheck Box26: OffCheck Box16: OffCheck Box47: OffCheck Box48: OffCheck Box49: OffCheck Box50: OffDropdown43: [Yes]YES / NO1: [Yes]Dropdown51: [Mother]Dropdown52: [Mother]Check Box58: OffCheck Box57: OffCheck Box52: OffCheck Box53: OffCheck Box54: OffCheck Box55: OffDropdown14: [01]Dropdown13: [01]Text11: Dropdown42: [01]Dropdown41: [01]Text63: Dropdown7: [MALE]Dropdown6: [MALE]Dropdown66: [Single]Dropdown67: [Single]Check Box108: OffCheck Box109: OffCheck Box110: OffCheck Box111: OffCheck Box72: OffCheck Box80: OffCheck Box78: OffCheck Box79: OffCheck Box73: OffCheck Box74: OffCheck Box75: OffCheck Box76: OffCheck Box77: OffCheck Box81: OffCheck Box82: OffCheck Box83: OffDropdown73: [Rental]Check Box84: OffCheck Box85: OffCheck Box86: OffCheck Box87: OffCheck Box88: OffCheck Box89: OffCheck Box92: OffCheck Box91: OffCheck Box90: OffText134: Dropdown68: [Computer]YES / NO2: [Yes]Dropdown5: [Bone Injury]Dropdown11: [Fits]Physical Disability Specify: Dropdown12: [Speech Impairment]YES / NO: [Yes]YES / NO3: [Yes]YES / NO4: [Yes]YES / NO5: [Yes]Text135: Dropdown74: [01]Dropdown75: [01]Dropdown76: [2018]Text136: Text137: Home Tel: Mobile: Name of Spouse of Main Applicant: NRICPPFIN_2: Home Tel_2: Mobile_2: Text138: Text139: Text140: Text141: Text142: Text143: Text144: Text145: Text146: Text147: Text148: Text149: Dropdown215: [BC]Dropdown214: [NRIC]Dropdown213: [NRIC]Dropdown212: [NRIC]Dropdown211: [NRIC]Dropdown204: [NRIC]Home Tel_9: Home Tel10: Mobile3: Name3: Name4: Dropdown208: [NRIC]Dropdown207: [NRIC]Dropdown210: [NRIC]Dropdown209: [NRIC]