lef applicationform

8/12/2019 LEF ApplicationForm

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* Please fill up all details in BLOCK letters or circle if applicable.

Name (Eng):

NRIC No.: Gender: Age:

Date of Birth: ____ (dd)/ ____ (mm)/ _______ (yy)

Permanent

Address:

Tel. No.: H/P: Others:

Correspondence

Address:(If different from

the above)

Email Address:

Highest Academic Qualication Obtained:

Extra-Curricular Activities (Organisation/Position):

Awards Obtained (Academic or Extra-Curricular Activities):

Name of Institution of Higher Learning:

Name of Course:

Course Duration (Total No. of years): Expected Course Completion:

Total Course Fees per year: RM .

I hereby certify that all the information provided above is true and correct.

Applicant's Date:Signature:

LEAr N FUND APPLICATION FORM

F / M

PERSONAL DETAILS OF APPLICANT

(Chinese):

(mm) (yy)

1)

2)

3)

1)

2)

3)

Current Year of Study in Course (eg. 1st year, 2nd year):

RM

RM

If you have received other scholarships or loans, please state scholarship name(s) & amount(s):

If you have applied for other scholarships or loans, please state scholarship name(s):

1) 2)

Nationality:

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Recent

Passport

Size

Photograph



Guarantor's Name (Eng):

NRIC No.: Date of Birth: ___ (dd)/ ____ (mm)_______ (yy)

Gender: F / M

Occupation: Monthly Income:

Home Address:

Tel. No.: H/P: Email:

Employer's or Company's Name & Address:

Tel. No.: Fax No.:


Guarantor's Date:

Signature:

Guarantor's Name (Eng):

NRIC No.: Date of Birth: ___ (dd)/ ____ (mm)_______ (yy)

Gender: F / M


Home Address:

Tel. No.: H/P: Email:

Employer's or Company's Name & Address:

Tel. No.: Fax No.:


Guarantor's Date:

Signature:

Relationship to Applicant:

RM

PERSONAL DETAILS OF GUARANTORS (2)


PERSONAL DETAILS OF GUARANTORS (1)

RM

Relationship to Applicant:

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(Chinese):

(Chinese):



1 Father/Guardian

Name: (Eng)

NRIC No.: Date of Birth: ____ (dd)/ _____ (mm)/ _______(yy)


2 Mother/Guardian

Name: (Eng)

NRIC No.: Date of Birth: ____ (dd)/ _____ (mm)/ _______(yy)


3 Siblings

No. of Siblings: No. of siblings in full-time education:

Age

No. of siblings under employment:


Applicant's Date:

Signature:

Name Name of School / College / University

FAMILY BACKGROUND OF APPLICANT


RM

RM

(Chinese):

(Chinese):

Occupation Monthly Income

RM

RM

RM

RM

RM

Name

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Referred by Lions Club of ______________________________

President's Secretary's

Signature: Signature:

President's Name: _______________________________ Secretary's Name: ___________________________

Date: _______________________________ Date: ___________________________

a) All applicants must fill in the official application forms of LEAr N Fund and affix a non-returnable latest passport

size photograph. Completed forms should be returned to: LEAr N Fund Selection Department.

Lions Selection Commi ttee

B-10-5, Block B, Megan Avenue 1,

189 Jalan Tun Razak, 50400 Kuala Lumpur.

b) Incomplete forms will not be entertained.

* SPM or STPM examination results

* SPM or STPM preliminary examination results

* School Testimonial and School Leaving Certificates

* All other certificates stated in the application form

* Identity Card

* Offer Letter from the Higher Education Institution stating the course name, course structure and fee structure

* EPF statement, income tax statement or any other proof of income of parents/guardians and/or siblings

* Two guarantors are required for this application

* One of the guarantors must be the parent/guardian of the applicant

* A copy of the identity card of the guarantor must be provided

* The guarantor must not be a bankrupt or undergoing bankruptcy proceedings


Please state briefly your main reasons for applying LEAr N Fund study aid:

APPLICATION PROCEDURE

c) Applicants must enclose certified copies of the following documents:

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LEAr N Fund:

Lions Education Assistance for the Needy Fund.

Lions Selection Committee:

The committee members appointed to carry out the interview session/s with the applicants and to decide on their

eligibility and the study aid value.

LEAr N Fund Agreement:

An official agreement between the applicant and Lions Education Foundation with all the terms and conditions stated

therein.

Study Aid:

Amount granted to the applicant by the LEAr N Fund.

1.1. The Applicant must be a Malaysian pursuing full time higher education and gained admission into any private or

public Institutions of higher learning (colleges or universities) in any academic disciplines in Malaysia excluding

drama, singing artists, beauty and the like.

1.2. The Institution of higher learning must be recognized by the Ministry of Education of Malaysia.

1.3. The Applicant must possess consistent and satisfactory academic records and/or active participation in

extracurricular activities in school.

1.4. The Applicant must not be older than 20 years for Diploma programmes and not older than 25 years for Degree

programmes.

1.5. The combined income of the parents must not exceed RM30,000 per annum.

2.1. The Applicant must be recommended or referred by any of the Lions Clubs in Malaysia.

2.2. The Applicant must attend an interview session conducted by the Lion Selection Committee and agreed that the

decisions made by the said committee are final and shall not be challenged.

2.3. Successful Applicant shall be bound by the terms and conditions set out in the LEAr

N Fund Agreement.

3.1. The study aid is Ringgit Malaysia Five Thousand (RM5,000) per annum only.

3.2. The Applicant shall be bound by the study aid repayment schedule set out in the LEAr N Fund Agreement

unless he/she secured a minimun CGPA3.80 and above for each and every semester term.

3.3. The life of the applicant shall be insured by Lions Education Foundation covering the study aid.


DEFINITION

1. APPLICANT'S ELIGIBILITY

2. APPLICANT'S OBLIGATIONS

3. STUDY AID COVERAGE

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lef applicationform

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