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SAMLING SCHOLARSHIP APPLICATION FORM Attach Recent Passport-sized Photograph here INSTRUCTIONS 1. Read through the

SAMLING SCHOLARSHIP APPLICATION FORM

Attach Recent

Passport-sized

Photograph

here

INSTRUCTIONS

1. Read through the criteria and form carefully before attempting to complete.

2. Complete and sign this form in own handwriting using English and return with 1 recent passport-sized photograph.

3. State N/A at those sections that not applicable to you.

4. Close sections with ‘*’ not applicable to you.

5. If space of this form is insufficient, please attach an addendum.

6. Arrange and attach documents according to the following sequence.

University/ College/ Polytechnic Acceptance Letter

Applicant’s Identity Card

Applicant’s Birth Certificate

SPM/ SPVM/ ‘O’ Level/ UEC Transcript

STPM/ ‘A’ Level/ Matriculation/ Pre-U/ Diploma Transcript and Certificate

Parents’/ Guardian’s Proof of income

Parents’/ Guardian’s Identity Card or Death Certificate and Pension Card

Applicant’s Saving Bank Book (first page only with saving account number)

7. All duplicate copy of above documents must be certified true copy. The originals should be

brought to a subsequent interview.

8. Post the completed application to Group Human Resource Department, PO Box 2919, 93756 Kuching, Sarawak.

CRITERIA FOR APPLICATION

1. Malaysian citizens only.

2. Students with excellent academic results seeking admission to or currently enrolled in a local university/ college/ polytechnic for full-time first degree or diploma course.

3. Must not be current recipients of scholarships awarded by other organisations.

4. Possess a dynamic personality, excellent communication skills and hold leadership positions in extra-curricular activities.

5. Keen to serve in Samling Group for a specified period upon graduation.

PART I

PERSONAL PARTICULAR

Name (as shown in NRIC):

 

Name in Chinese (if Chinese applicant):

Permanent Home Address:

 

Postal Address:

Postcode:

Postcode:

City & State:

City & State:

NRIC No.:

Date & Place of Birth:

 

Home Tel. No.:

H/p No.:

 

Email Add.:

Marital Status:

Citizenship:

 

Race:

PART II

COURSE DETAIL

Course Enrolled:

University:

 

Campus:

Course Duration:

Commencement Date (mm/yy):

Completion Date (mm/yy):

Tuition Fee: RM

Other Fees: RM

 

Accommodation: RM

Ration: RM

Transportation: RM

 

Other Expenditure: RM

PART III

GUARDIAN & PARRENTS DETAIL

Father/ Guardian’s* Name:

 

Mother’s Name:

 

NRIC/ Passport* No.:

 

NRIC/ Passport* No.:

 

Marital Status:

 

Marital Status:

 

Age & Citizenship:

 

Age & Citizenship:

 

Home Add.:

 

Home Add.:

 

Postcode:

Postcode:

City & State:

City & State:

Home Tel. No.:

 

Home Tel. No.:

 

H/p No.:

 

H/p No.:

 

Occupation:

 

Occupation:

 

Gross Monthly Income:

 

Gross Monthly Income:

 

Employment Status:

Employment Status: Full-time Retired Part-time Own Business

Full-time

Employment Status: Full-time Retired Part-time Own Business
Employment Status: Full-time Retired Part-time Own Business

Retired

Part-time

Own Business

Employment Status:

Employment Status: Full-time Retired Part-time Own Business

Full-time

Employment Status: Full-time Retired Part-time Own Business
Employment Status: Full-time Retired Part-time Own Business

Retired

Part-time

Own Business

Name and Add. of Employer/ Own Business (If

Name and Add. of Employer/ Own Business (If

retired, state name and address of previous employer/ own business.)

retired, state name and address of previous employer/ own business.)

Office Tel. No.:

 

Office Tel. No.:

 

PART IV

SIBLING PARTICULARS

Name

NRIC No.

Marital

No. of

Occupation (If studying, state status & name of school/ employer.)

Tel. No./

Gross

Status

Children

H/p No.

Monthly

(if any)

Income

PART V

ACADEMIC RECORDS & EXTRA-CURRICULAR ACHIEVEMENTS

Qualification Standard SPM/ SPVM/ ‘O’ Level/ UEC* STPM/ ‘A’ Level/ Matriculation/ Pre-U/ Diploma*
Qualification Standard
SPM/ SPVM/ ‘O’ Level/
UEC*
STPM/ ‘A’ Level/
Matriculation/ Pre-U/
Diploma*
University/ College/
Polytechnic
Examination Results*
Name of School/
College/ Polytechnic/
University
Commencement Year
Completed Year
Overall Grade/ Result
Subjects & Grades (list
down)
Co-curricular
Achievements (list down
activity with position level and
award/prize)

PART VI

FINANCIAL ASSISTANCE

Name of Loan or Scholarship

Name of Organisation

Year Received

Amount per

annum

PART VII

REFERENCE (Provide two referees who are known to you and your family for a period not less than 3 years. At least one should be competent to give an assessment of your school/academic life.)

Name:

Name:

Home Add.:

Home Add.:

Postcode:

Postcode:

City & State:

City & State:

Home Tel. No.:

Home Tel. No.:

H/p No.:

H/p No.:

Occupation:

Occupation:

No. of years Known:

No. of years Known:

Relationship to Applicant:

Relationship to Applicant:

PART VIII

OTHER INFORMATION (Other information to support your application e.g. why parents cannot afford to sponsor your study, why we should offer you)

PART VIII

DECLARATION

I hereby declare that the information given by me in this application are true, complete and correct to the best of my knowledge and belief. I understand that any false statements or withholding of any relevant information may provide grounds for the withdrawal of any offer.

Name of Applicant

Signature of Applicant

Date of Application