MOE Bursary Application (Part-Time Diploma) AY2017/2018 Important Notes 1. Complete the application form with clear and legible writing. It will take about 15 minutes to complete the form. 2. Do not use correction tape or fluid on this application form. Cancel and counter-sign against amendment instead. 3. Drop the completed application form with all required supporting documents (in sealed envelope, labelled Bursary Application, Admin Number & Name) into TSA drop-in-box by 9 November 2017. I STUDENT PARTICULARS Diploma: Admission No: Name as in NRIC: Modular Cert (MC) / Semester of Study: *1 / 2 / 3 / 4 / 5 Home Address: Mobile No.: Citizenship: * S porean / SPR / Others Email: II PARTICULARS OF FAMILY MEMBERS (Immediate and non-immediate family members living together) Name Age Relationship to Student 1. Self NRIC / BC No. Marital Status Occupation For Student state in ( ) Pri, Sec, ITE, Poly, Uni Gross monthly income + other sources of income ($) 2 3. 4. 5. 6. 7. 8. III - ARE YOU CURRENTLY APPLYING FOR OR IN RECEIPT OF ANY OTHER BURSARY / SCHOLARSHIP / STUDY GRANT FOR AY17?. (Pls tick where applicable) Total Monthly Income (A) No Yes (Pls specify: ) IV ACKNOWLEDEGMENT BY MOE BURSARY APPLICANT PCI = A no. pax in hse hold 1. I declare that the information and supporting documents supplied in this application are true and correct. I did not willfully withhold or suppress any other relevant information. 2. I understand that : a) submission of any false information will render my application void and that I will be required to refund to TP the full value of bursary received. b) I have to refund full value of bursary received if I voluntarily withdraw from my course of study or receive any other ^scholarship/bursary/study award in the same academic year; c) TP cannot take responsibility for payment made to the wrong bank account, delayed payment or non-payment of the bursary if I fail to give sufficient notice of any change to details of my bank account; d) the decision of the Bursary Committee is final. 3. I have no objection for TP to share the information given herein for statistical purposes. I can review TP s privacy statement online at http://www.tp.edu.sg/privacystatement. Applicant s Signature: * Pls delete where applicable Date: SCC0040 (VER.09), Last updated: 11/10/2017 1
BURSARY APPLICATION DECLARATION OF INCOME I, Mr/Mdm/Ms,NRIC No:, *spouse/parent/guardian/sibling/relative of (applicant s name), hereby declare that:- Pls tick where applicable: My occupation is and my current income is $ per month. (I enclosed my last 6 months CPF Contribution & Transaction History.) For self-employed person, latest Notice of Income Tax Assessment must be provided. I am currently unemployed. I am a housewife with income of $ per month. I am a retiree with *pension/income of $ per month. (I enclosed my last 6 months CPF Contribution History. Required only if you are 70 years old and below.) I declare that the information provided above is true and to the best of my knowledge and I understand that if the information provided is false, this application will be rejected. The applicant also undertakes to refund the full value of this financial assistance received if any of the information above is subsequently found to be falsely declared. Signature of Informant Date BURSARY APPLICATION DECLARATION OF INCOME I, Mr/Mdm/Ms,NRIC No:, *spouse/parent/guardian/sibling/relative of (applicant s name), hereby declare that:- Pls tick where applicable: My occupation is and my current income is $ per month. (I enclosed my last 6 months CPF Contribution & Transaction History.) For self-employed person, latest Notice of Income Tax Assessment must be provided. I am currently unemployed. I am a housewife with income of $ per month. I am a retiree with *pension/income of $ per month. (I enclosed my last 6 months CPF Contribution History. Required only if you are 70 years old and below.) I declare that the information provided above is true and to the best of my knowledge and I understand that if the information provided is false, this application will be rejected. The applicant also undertakes to refund the full value of this financial assistance received if any of the information above is subsequently found to be falsely declared. Signature of Informant Date * Pls delete where applicable. / Do produce more copies for family members to declare their income (if necessary). SCC0040 (VER.09), Last updated: 11/10/2017 2
MOE BURSARY (P/T DIPLOMA) AY2017/2018 APPLICANT TO NOTE: 1) Bursary Committee will award quantum based on applicant s eligibility:- a. Singapore Citizen b. Students pursuing a part-time diploma for the first time (not including repeat students for the Semester/Module) c. Not receiving other scholarships / bursaries in AY2017/2018. However, students who are awarded scholarships/bursaries/study awards that cover tuition fees only can concurrently hold the MOE Bursary. d. Gross monthly household per capita income (PCI)** of $1,900 Gross Monthly PCI** Award Quantum per Modular Certificate $1,400 and below $495 Between $1,401 to $1,900 $250 Note : Students to apply bursary on semester basis. 2) Per Capita Income (PCI)** = Total Gross Monthly Income of ALL family members^ Number of family members^ ^ Family members living together in the same household, as reflected on the NRIC 3) Definition of Total Gross Monthly Family Income a. Includes employee s CPF contributions, income contributions from self-employment, business or salaried employment which include basic salary, allowances, overtime pay and other sources of income such as rent, alimony, pension etc. b. If bonuses are declared it should be computed as one twelfth of the annual wage supplements and bonuses received in the last twelve months. c. The monthly financial support from divorced/separated parent or spouse such as alimony and contributions to support children/household should be included. d. National Service (NS) allowance earned by NSF is excluded. 4) Application Procedure a. Drop the completed application form with all required supporting documents (in sealed envelope, labelled Bursary Application, Admin Number & Name) into TSA drop-in-box by 9 November 2017. b. Students are to apply bursary on modular/semestral basis. c. For any enquiries, please email to Student Care & Counselling at care@tp.edu.sg. 5) Notification of Application Status via Student s TP Email Account a. Email notification on application status will be sent to applicants within 7 working days upon receipt of application. b. Successful applicants will be notified by email on the award disbursement by December 2017. SCC0040 (VER.09), Last updated: 11/10/2017 3
Bursary Application Supporting Documents Checklist Please tick in appropriate boxes. Copy of the supporting documents to be provided: 1. a) NRIC of applicant & ALL family members (both sides) b) For Full-time National Servicemen - photocopy of green SAF 11B (both sides) c) Birth Certificate only for those below 15 years of age d) Death, separation or divorced certificate 2. a) Admission cards of family members studying in Poly / ITE / University b) Enrolment letter for sibling who is awaiting entry to Poly / ITE / University c) NS Enlistment letter for sibling who is awaiting for NS 3. Applicant / family members who are employed Latest Payslip 4. Applicant / family members who are unemployed / retired / housewife or employed but not able to produce payslip, must provide:- a) CPF Contribution History for the last six months (eg. Apr 17 to current month) AND b) Income declaration form (Page 2) 5. Applicant / family members who are self-employed (eg. taxi driver, hawker etc): a) CPF Contribution History for the last six months (eg Apr 17 to current month ) AND b) Income declaration form (Page 2) AND c) Notice of Income Tax Assessment 2017 Go to http://www.iras.gov.sg/irashome/default.aspx Log in to My Tax Portal using SingPass or IRAS Pin Select View Notices Select Letters/Notices Select Notice of Assessment (Individual) for 2017 Print Notices of Assessment for 2017 If family member who is self-employed and not required to submit Income Tax Return, please submit View Individual Tax Notices page: Go to http://www.iras.gov.sg Log in to My Tax Portal using SingPass or IRAS Pass Select Notices Select Individual Print View Individual Tax Notices page (which list the year of Income Tax Assessment) 6. Interbank GIRO Form (Page 5) 7. The front page of applicant s bank book OR Top portion of applicant s bank statement (with information of A/C holder name & A/C No.) Item 6 & 7 are not required for last year MOE Bursary awardees Note 1) CPF members with SingPass can obtain CPF Contribution and Transaction History Statement from CPF Board website at http://www.cpf.gov.sg 2) Please approach CPF branches or Community Centres in person with NRIC or call CPF hotline:1800-227-1188 to obtain SingPass SCC0040 (VER.09), Last updated: 11/10/2017 4
Finance & Administration Department 21 Tampines Ave 1 Singapore 529757 Attn : Part-Time Student (CET) Financial Matters INTERBANK GIRO FORM (MOE BURSARY FOR CET COURSES) NOTES: 1. Please note that all fields below are compulsory. 2. Upon completion, submit the original form with your MOE bursary application: a. The front page of your bank book OR b. Top portion of your bank statement (information of account holder name & account no.) 3. Any alterations to the bank account information on this form must be endorsed by the bank account holder. No correction fluid is to be used. 4. This form is not required for last year MOE bursary awardees. Please credit all monies due to me to my bank account as per provided given below. Student s Particulars Name as per NRIC (In block letters): NRIC No: Admin No: Contact No: Email: Mailing Address: Name of Account Holder As Per Bank s Record: Name of Banker (e.g. DBS Bank; POSB etc.): Our Bank Code, Branch Code and Bank Account No: Bank Code Branch Code Account to be credited I certify that the bank account above belongs to me and undertake to accept full responsibility for payment credited to the above bank account. Amounts so credited shall constitute valid discharge of obligations due to me. This authorisation shall continue to be in force until I have expressly revoked it by notice in writing delivered to you. In the event of a change of bank account, I shall inform you in writing 30 days in advance of the change. Name of Bank Account Holder Signature of Bank Account Holder/ Date SCC0040 (VER.09), Last updated: 11/10/2017 5