sin chew scholarship

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 1 ( ) : ( ) Full Name (as shown in IC) (Course No. ) 要 要 要  Summary (  This summary has to be filled in clearly by applicant ) 1.  西  (SPM): _________A(s), Chinese Language Subject: ______ A (  A Level): _________A(s) □   西 (  STPM) CGPA: __________/ or _________A(s), Chinese Language Subject: ______ □   (UEC): _________A(s), Chinese Language Subject: ______ ( o r )  Other academic qualifications: ___________ 2. / Parents/ Guardian’s Last Year Total Annual Gross Income: _________________________ 3. / Academic Awards / Other achievements : 4. Extra-Curricular Activities :  _______________________________________________________________________________________________     For Office Use  : Date Application Received:  (Documentation Required): □ Photocopy of result: SPM/ STPM/ or other equivalent certificates: ____ □ Latest Form J (Income Tax Return) or EA For m or Pay Slip or Self-Assessment Form of Applicant's parents/guardian. □ Complete set of documentation.  : Recommended for interview : □  是 (Yes) □  否 (No) 註 (Remarks):   Authorized signatory of Selection Panel

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F. (Health Condition)

(Please state present health condition, details of any illness, disability or incapacity.)

G. (Reason(s) for Application)

(Your reason(s) for this scholarship application.)

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H. Details of Family Background

(Father) (Mother)( ) ( )

Name( ) ( )

( ) ( )

IC No. ( )

:

Age: ( )

:

Age:

Home Address _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

(Post Code): _________________

(Tel) : ____________________(Handphone): ____________________

_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

(Post Code): _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

(Tel) : ____________________(Handphone): _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Occupation:

Name of Employer

Address of Employer

_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

(Post Code): _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

(Tel) : _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

( F a x ) : _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

(Post Code): _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

(Tel) : _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

( F a x ) :____________________

I. Guardian ( ( ( ( ) )) )

( )( )

IC No. ( )

:

A g e :Name( )

Occupation

HomeAddress

_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ (Post Code): _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

(Tel) : _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ (Handphone): _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

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/ // / (Details of Parents’/Guardian’s Own Business):/ :

Name and Address of Business

( T e l ) :

( F a x ) :

:

Business Nature:?

Establishment of Business

_ _ _ _ _ _ _ (years)_ _ _ _ _ _ (months)

? □ □

Is the business wholly owned?/

Please state share held by parents/ guardian, if inpartnership or joint venture.

/ // / ( ( ( ( ) )) )

Parents/ Guardian’s Last Year Annual Gross Income( R M )

Father( R M )

Mother( R M )

Guardian( R M )

Total

As employee

Own Business

Rental Income

Others

Total

Expenditures of Family:

Items Monthly (RM) Yearly (RM)/

House Installments/ Rental

(

/

/

)Loan Repayment (motor vehicles/ appliances, etc...)

/

Electricity/ Water/ Telephone_ _ _ _ _

Education for ____ children

Others expenses

Total

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/ // /

Names and Particulars of Siblings/ Other Dependents

Name

Relations

Age

MaritalStatus

Occupation

(RM)

Annual Income

( )

( )

( )

( )

( )

( )

( )

( )

( )

( )

( )

( )

J Referees

( ) ( ):

Name( )

:

Name( )

:

Address

(Tel):

:

Address

(Tel)::

Occupation:

Occupation

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: :: :

The following documents must be submitted together with the Application Form:

1 .

□ (Yes) □ (No)Have you been awarded any scholarship before?

If “Yes”, please supply the following information:

Year/

University/ College Course Sponsorship unit

2 .

□ (Yes) □ (No)Has any of your siblings (brother(s)/sister(s)) benefited from other education funds?

If applicable, please supply the following information: -

Name Relationship Course College YearAdmitted

3 .

□ (Yes) □ (No)Has any of your siblings (brother(s)/sister(s)) applied to this Fund?

1 .

( )

Identity Card (both sides)

2. Birth certificate

3 .

/ / /

SPM/STPM/UEC/Other equivalent qualifications.

4 .

Testimonial(s) and record(s) of participation in extra-curricular activities

5 .

/ ( ) / /

Latest Form J (Income Tax Return) / EA Form/ Self-Assessment Form of Applicant’s parents/guardian

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: / “ ” Recital: Sin Chew Media Corporation Berhad shall hereinafter be referred to as the “SCMCB”.

You are required to read the procedures, requirements, terms and conditions herein below carefully before submitting yourapplication.

Procedures:

Please note that any false particulars, information, documents, untruthful material facts or misrepresentations will subjectyou to disqualification. The application form should be printed out clearly or be written legibly and must be accompanied bythe required documents and must be submitted before the published closing date. Proof of posting is not proof of receipt. Theselected course(s) must be clearly written or printed on the top left hand corner of the envelope. The “Sin Chew DailyEducation Fund” ’s address is as follows:

Sin Chew Daily Education FundSin Chew Media Corporation Berhad (“SCMCB”)19 Jln Semangat46200 Petaling JayaSelangor Darul Ehsan

(Please note that proof of posting is not proof of receipt.)

:Terms and Conditions:

The following terms and conditions shall apply to all applications: -

1. 2010 1 1 26 The applicant must be a Malaysian citizen below 26 years of age as at 1 st January 2010.

2. /A / / Students must possess good results in SPM/A-Level/ STPM/ UEC or other equivalent qualifications.

3. Students must be active in sports and extra-curricular activities.

4. / Students must not be bonded or in receipt of any financial aid or rewards from other educational organisations orinstitutions.

5. The applicants must produce original copies of the examination results and all other relevant documents during the

interview.

SPM 14

Application deadline: 14 th day after theannouncement of SPM Result. If not, please refer toour Sin Chew Daily for the latest deadline.

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6. The selection committee’s decision in all matters pertaining to the selection of the scholarship award is final and noappeal, inquiry or correspondence will be entertained.

7 .

/

Students must meet the minimum requirement set by the Colleges/ Universities in order to be qualified for selection.

8 .

Different colleges, universities and courses have different entry requirements. Please liase directly with the colleges oruniversities concerned for more details.

9. “ ”

The recipient is not to discontinue or switch Course or to take up any full or part time employment while pursuing thesaid Course without the prior written approval of “SCMCB” or The College/ University concerned unless suchemployment is part and parcel or related to the said Course

10. “ ”

The recipient is not allowed to participate in any form of illegal activity or join any unlawful organisations which in theopinion of “SCMCB” or The College/ University would embarrass or cause disrepute to all parties concernedthroughout the study period.

11.

The recipient is to attend all classes, lectures, tutorials and lessons as required by the said Course regularly anddiligently unless he or she is medically unfit to do so.

12.

The recipient is required to obey all rules and regulations of the participating College/ University at all time and isexpected to conduct himself/herself in a respectable manner.

13. “ ”

The participating College/ University and “SCMCB” are not obligated to extend the award beyond the existingacademic period.

14. “ ” “SCMCB” reserve their right to add or amend the rules and regulations contained herein without prior notice. Nocomplaint whatsoever shall be entertained.

15. “ ” / /

The awards are not directly offered by “SCMCB” but are offered by the participating educational institutions or othersponsors through “SCMCB” and the recipient may be required to sign a bond directly with the participating Colleges/ Universities if required to do so.

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APPLICANT’S DECLARATION

1 .

“ ”

2 .

“ ”

3 .

“ ” “ ” / / /

“ ”

“ ”

4 .

5 .

6 .

“ ”

7 .

1. I declare that the information given herein are true and accurate to the best of my knowledge and belief. If at any time hereafter suchinformation are found to be untrue or false or misleading due to willful neglect, “SCMCB” shall be at liberty to take actions againstme, including the withdrawal of any benefit already granted to me and the recovery of all losses sustained by “SCMCB” or suchfurther actions deem fit and proper by “SCMCB”.

2. I agree that the award is not a direct grant of “SCMCB” but is granted by the participating Colleges/ Universities through “SCMCB”and as such any failure to honor the scholarship award by way of discontinuance, termination, suspension or variation by the collegeor the university concerned shall not be the fault or liability of “SCMCB” and I agree that no legal actions whatsoever shall be takenagainst “SCMCB” by me and/ or my parents or guardian(s).

3. I agree to complete the course of study within the stipulated time and to furnish my progress reports or examination results as may berequested by “SCMCB” from time to time.

4. I understand that I may be required to sign a bond document or to provide security or surety prior to the award of the said scholarship.

5. I confirm, accept and agree to be bound by all the terms and conditions as stated in this application.

6. I further declare that I am fully aware that the scholarship award, if granted by “SCMCB”, will not be in the form of cash award butwill be in the form of academic courses to be offered by the participating colleges and/ or institutions of higher learning with thetuition fees and/ or such other incidental expenses included.

7. I agree that in the event of conflict between the Chinese and English versions as stated in this application, the English version shallprevail and shall be the principal and primary text of interpretation.

Name of Applicant __________________________ I/C No ________________________________

Signature of Applicant _________________________Date _______________________