BURSARY APPLICATION FOR CURRENT STUDENTS - AY2017/2018 Applications must be submitted (by post or by hand) on the prescribed form to : Division of Student Administration (Academic Administration) Block E Level 2, LASALLE College of the Arts 1 McNally Street, Singapore 187940 (Attn : Ms Audrey Tan) Enquiries : scholarshipandbursary@lasalle.edu.sg Closing Date : Wednesday, 21 June 2017, 5pm Successful applicants will be notified via email and letter at the end of 2017. If you are sending your application by courier or post, please ensure that it arrives at LASALLE by the deadline. Late or incomplete applications will not be considered. BURSARY APPLICATION DOCUMENT CHECKLIST (These documents must be submitted together with your bursary application form.) Please þ tick A completed & signed Bursary Application Form ; Photocopy of your June 2017 result slip ; If you are a current LASALLE Diploma Level 3 student applying to the BA programme in August 2017, please include a photocopy of your Letter of Offer to the BA programme ; For family members who are employed : Latest payslips and/ or latest IR8A form and CPF Contribution & Transaction History for the past 12 months ; For family members who are self-employed (eg taxi drivers, hawkers) unemployed / retired / housewife / working freelance : Latest Income Tax Assessment (IR8A) for self-employed family members; Signed Income Declaration Form and CPF Contribution & Transaction History for the past 12 months ; Photocopies of your NRIC and all NRIC (front & back), SAF 11B for SAF Personnel and student concession pass / matriculation cards of declared family members / household members, birth certificates for family members below age 15 ; Photocopy of scholarship / grant / financial assistance / government assistance letters awarded (if applicable) ; Photocopy of death, separation or divorced certificates (if applicable) ; Monthly financial support from divorced / separated parent or spouse such as alimony and contributions to support children / household (if applicable) ; Any other documents that might support your case eg. medical reports of family members with chronic illnesses & latest 3 months medical bills etc. ; GROSS MONTHLY HOUSEHOLD INCOME (GHI) : Gross monthly income of immediate family members, including both parents or spouse who may or may not be living with applicant ; Gross monthly income of non-immediate family members, including grandparents, siblings, spouses of siblings and any other relatives living together with the applicant ; Includes employee s CPF contributions, income contributions from self-employment, business or salaried employment which includes basic salary, allowances, overtime pay and other sources of income such as rent, alimony, pension etc ; If bonuses are declared, it should be computed as one twelfth of the annual wage supplements and bonuses received in the last 12 months ; The monthly financial support from divorced / separated parent or spouse such as alimony & contributions to support children / household should be included; National Service (NS) allowance earned by NSF is not included ; PER CAPITA INCOME (PCI ) : Total Gross Monthly Household Income of ALL Family Members No. of family members in the same household IMMEDIATE & NON-IMMEDIATE FAMILY MEMBERS For Unmarried / Single Applicants For Married / Separated / Divorced Applicants Immediate Family Members Parents of applicant (regardless if applicant lives with the applicant) Spouse & all children of applicant (regardless if applicant lives with spouse or children) Non-Immediate Family Members Grandparents, siblings, spouses of siblings & any other relatives living at the same address with the applicant. Parents, grandparents, siblings, spouses of siblings or any other relatives living at the same address with applicant. CONDITIONS All bursaries / scholarships do not cover miscellaneous fees & student insurance. Where applicable, disbursement of bursary / scholarship funds will be in equal amounts for each semester and credited into the successful student s fee account at the College. Please note that the student is liable for any remaining fees payable. Awards must be used for the period for which they were awarded, and no amount of the award may be carried forward. Successful candidates must pursue the course faithfully and sit for all prescribed assessments/examinations. The College reserves the right to review, withdraw, or suspend at any time any bursary in full or partially if any of the conditions are not met. The College s decision on any award and its value is final. The College will not enter into any correspondence on the reasons for the decision. All materials & documents submitted will not be returned. Applicants are to make a copy of their application for their own record. Applicants receiving the Skills Future Mid-Career Enhanced Subsidy may apply for the MOE or CDC Bursary if they meet the eligibility & per capita income (PCI) criteria. Submission of an application does not guarantee any award. Application For Bursary for CURRENT Students 1
BURSARY APPLICATION FOR CURRENT STUDENTS - AY2017/2018 Important Notes : 1. Applicants need to submit only ONE application and will be automatically considered for ALL BURSARIES. The Scholarship & Financial Assistance Committee decides on the award of bursary to students. 2. Eligible applicants will be considered for either the MOE Bursary, the CCC/CDC Bursary or the CDAC Youth Empowering & Aspiration Programme (YEAP) based on their per capita income (PCI) or Gross Household Income (GHI) criteria. There is no need to submit a separate application for the for the CDC / MOE Bursary / YEAP when Semester reopens in August. 3. All applicants will be notified via college email and/or letter of their respective bursary award(s) at the end of July 2017. For Official Use : Applicant s PCI : Pending Documents : 1. APPLICANT S PERSONAL PARTICULARS Full Name (As in NRIC/Passport): NRIC No : Race : Date of Birth (DD/MM/YY): Age : Student ID : Type of Study Please þ tick: Diploma, Level BA, Level MA, Sem Programme (eg. Fine Arts) : Applicant s Marital Status Please þ tick: Single Married Separated Divorced Widowed Mailing Address: Postal Code : Nationality: Singapore PR: Yes No Your June 2017 Grade Average : Are you Trailing Credits: Please þ tick: No Yes credits Email Address: Home No: Mobile No: Current Full-Time/Part-time/Freelance Employment (if any) : Employer (eg. Starbucks) : Gross Income / Month (SGD) : Please list other external scholarships / bursaries / grants / subsidies that you are receiving or have applied for in AY2017/2018 : Name of Financial Scheme Eg. Scholarship /Bursary/ Grant Name of Sponsor Eg. Lee Foundation / NAC Period of Grant Eg. Aug 2017 Jan 2018 Value per Academic Year (SGD) Status Eg. Pending/Approved/Rejected 1. 2. For Singaporean Malay students only : Are you applying for the Mendaki Tertiary Tuition Fee Subsidy (TTFS)? If it has been approved, please indicate percentage of subsidy approved : 50%, 75%, 100% * Yes No 2. FAMILY S PERSONAL PARTICULARS (Please list all immediate & non-immediate family living at the same address. You may use a separate sheet of paper to indicate this if there is insufficient space on the form.) Occupation Gross Income / Relationship to Applicant Full Name (As in NRIC / Passport) Age (if student, please state Pri, Sec, Poly, Uni) Month (SGD) 1. Father 2. Mother 3. Sibling 4. Sibling 5. 2
For families with $0 - $200 total family income, please state source of funds for daily expenses: Please þ tick ; Rental of Room : Please attach updated rental agreement. Family members / Relatives not residing at the same address Private / Government Financial Aid eg MSF ComCare : Others : a) Are you paying your tuition fees through CPF? Yes No b) Are you paying your tuition fees through the Post Secondary Education Account (PSEA)? Yes No c) Are you on MOE Tuition Grant? Yes No d) You are staying in a : HDB flat : 1 Room/ 2 Room / 3 Room / 4 Room / 5 Room / Maisonette / Exec Condo * Landed Property Private Apartment / Condominium e) Your residence is : Rented Mortgaged Partially Paid Fully Paid Please indicate below the name(s) of your siblings who are in receipt of or who is/are applying for the MOE / CDC Bursary. Name of Sibling : Name of Sibling : Name of Sibling : 3. DECLARATION 1. I declare that all the particulars given and informed in this application are true and correct. I did not wilfully withhold or suppress any other relevant information. 2. I understand that : a) Submission of any false information will render my application void and I will be required to refund LASALLE College the full value of the bursary / scholarship received ; b) I have to refund the full value of the bursary / scholarship received if I voluntarily withdraw / intermit from my studies ; c) The bursary / scholarship awarded will be used for the payment of tuition fees ; d) The College reserves the right to allot my application to a bursary / scholarship (subject to eligibility) and the decision of the College is final; e) The College reserves the right not to disclose its reasons for approving or disapproving an application; f) The College reserves the right to withdraw or suspend at any time any bursary / scholarship in full or partially if any conditions are not met; g) The documents submitted with this application will not be returned ; 3. By submitting my personal data & my family members personal information, I consent to the College collecting, using & disclosing my personal data & my family s personal information for communication, administrative, academic purposes, research & statistical reporting (whether by LASALLE or a third party and whether initiated by LASALLE or any relevant government authority). Signature of Applicant Date 3
BURSARY APPLICATION Income Declaration Form This form is for use by family members or relatives living in the same household who are either : self-employed, this form is to be completed if he/she is unable to provide his/her payslip ; unemployed (including housewife / retirees) ; One declaration form per family member. Please make more copies if needed. I, Mr/Mdm/Ms, of NRIC Number, hereby declare that : I am self-employed. My occupation is and my current income is S$ per month. (I enclose my IR8A Form, last12 months CPF contribution & Transaction History* as evidence of non-employment.) I work on a part-time/free-lance basis. My occupation is and my current income is S$ per month. (I enclose my latest IR8A form, last 12 months CPF Contribution & Transaction History*.) I am currently unemployed. (I enclose my last 12 months CPF Contribution & Transaction History* as evidence of non-employment.) I am currently unemployed but I have income of S$ from renting out a room in my flat. (I enclose my last 12 months CPF Contribution & Transaction History* as evidence of non-employment & copy of rental agreement) I am currently unemployed but I have relatives who assist me with S$ for monthly expenses. (I enclose my last 12 months CPF Contribution & Transaction History* as evidence of non-employment.) I am currently unemployed and receiving S$ as monthly financial aid from the ministry / government. (I enclose my last 12 months CPF Contribution & Transaction History* & a copy of financial aid letter from the ministry / government) I am a housewife. (I enclose my last 12 months CPF contribution & Transaction History* as evidence of non-employment.) I am a retiree with a pension/ income of S$ per month. I enclose my last 12 months CPF Contribution & Transaction History* & evidence of retirement from full-time employment) * Note : 1. CPF members with Singpass can obtain their CPF Contribution & Transaction History Statement from the CPF Board website at www.cpf.gov.sg 2. Please approach CPF Braches or Community Centres (CC) in person with NRIC to obtain Singpass or call CPF hotline at 1800-227 1188. I declare to the best of my knowledge, that the particulars above are true and correct. If there is a deliberate false declaration of my financial status on this form, the College has the right to withhold the disbursement of bursary / scholarship. The bursary / scholarship applicant also undertakes to refund the full value of the award if any of the above information is subsequently found to be falsely declared. Family Member s Signature Relationship to Applicant Name of Student / Applicant 4
BURSARY APPLICATION Income Declaration Form This form is for use by family members or relatives living in the same household who are either : self-employed, this form is to be completed if he/she is unable to provide his/her payslip ; unemployed (including housewife / retirees) ; One declaration form per family member. Please make more copies if needed. I, Mr/Mdm/Ms, of NRIC Number, hereby declare that : I am self-employed. My occupation is and my current income is S$ per month. (I enclose my IR8A Form, last12 months CPF contribution & Transaction History* as evidence of non-employment.) I work on a part-time/free-lance basis. My occupation is and my current income is S$ per month. (I enclose my latest IR8A form, last 12 months CPF Contribution & Transaction History*.) I am currently unemployed. (I enclose my last 12 months CPF Contribution & Transaction History* as evidence of non-employment.) I am currently unemployed but I have income of S$ from renting out a room in my flat. (I enclose my last 12 months CPF Contribution & Transaction History* as evidence of non-employment & copy of rental agreement) I am currently unemployed but I have relatives who assist me with S$ for monthly expenses. (I enclose my last 12 months CPF Contribution & Transaction History* as evidence of non-employment.) I am currently unemployed and receiving S$ as monthly financial aid from the ministry / government. (I enclose my last 12 months CPF Contribution & Transaction History* & a copy of financial aid letter from the ministry / government) I am a housewife. (I enclose my last 12 months CPF contribution & Transaction History* as evidence of non-employment.) I am a retiree with a pension/ income of S$ per month. I enclose my last 12 months CPF Contribution & Transaction History* & evidence of retirement from full-time employment) * Note : 3. CPF members with Singpass can obtain their CPF Contribution & Transaction History Statement from the CPF Board website at www.cpf.gov.sg 4. Please approach CPF Braches or Community Centres (CC) in person with NRIC to obtain Singpass or call CPF hotline at 1800-227 1188. I declare to the best of my knowledge, that the particulars above are true and correct. If there is a deliberate false declaration of my financial status on this form, the College has the right to withhold the disbursement of bursary / scholarship. The bursary / scholarship applicant also undertakes to refund the full value of the award if any of the above information is subsequently found to be falsely declared. Family Member s Signature Relationship to Applicant Name of Student / Applicant 5