SCHOLARSHIP APPLICATION FOR NEW STUDENTS - AY2018/2019

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SCHOLARSHIP APPLICATION FOR NEW STUDENTS - AY2018/2019 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 1) Application Period for MA in Arts Pedagogy & Practice : 1 February - 25 April 2018 Successful MA / PostGrad Diploma applicants will be notified via email & letter by end May 2018. 2) Application Period for for all other Programmes : 1 February 16 May 2018 Successful applicants will be notified via email and letter by end June 2018. 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. SCHOLARSHIP APPLICATION DOCUMENT CHECKLIST (These documents must be submitted together with your scholarship form.) Please þ tick A completed & signed Scholarship Application Form with 1 passport-sized photograph ; Photocopy of your AY2018/2019 Letter of Offer from LASALLE & Course Fee Schedule ; A typed A4-sized 500-word statement on personal interest & achievement in relation to the programme of study ; A typed A4-sized curriculum vitae or resume (include record of activities / awards) ; Photocopies of your most recent transcripts & certificates ; Photocopy of your NRIC (front & back) or Passport for international students ; Photocopy of scholarship / grant / financial assistance letters awarded (if applicable) ; In addition to the above, applicants who wish to be considered for the Dare to Dream Scholarship or Kumpulan Akitek Arts Scholarship must submit the following : Medical reports / Doctors letter(s) certifying medical condition (FOR DARE TO DREAM SCHOLARSHIP APPLICANTS); For family members who are employed : a. Latest payslips and/ or latest IR8A form and b. CPF Contribution & Transaction History for the past 12 months ; For family members who are self-employed (eg taxi drivers, hawkers, property agents etc) unemployed / retired / housewife / working freelance : a. Latest Income Tax Assessment (IR8A) for self-employed family members ; b. Signed Income Declaration Form and c. CPF Contribution & Transaction History for the past 12 months ; Photocopies of 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 death, separation or divorced certificates (if applicable) ; CONDITIONS All bursaries / scholarships do not cover miscellaneous fees & student insurance. Disbursement of bursary / scholarship funds will be will be divided into 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 retention & record. Submission of an application does not guarantee any award. Applicants receiving the SkillsFuture Mid-Career Enhanced Subsidy are not eligible to hold a college-administered bursaries / scholarships. However, they may apply for the MOE or CDC Bursary if they meet the eligibility & per capita income (PCI) criteria. 1

SCHOLARSHIP APPLICATION FOR NEW STUDENTS - AY2018/2019 Important Notes : 1. Submit the completed & signed application form with all required documents by the deadline to LASALLE, Student Administration, Block E Level 2. 2. Successful applicants will be notified via letter & email by end June 2018. Please þ tick if you wish to be considered for the Dare to Dream Scholarship : I wish to be considered for the Dare to Dream Scholarship and have enclosed my family s financial documents & medical reports of my condition. Please attach passport-sized photograph here Please þ tick if you wish to be considered for the Kumpulan Akitek Arts Scholarship : I wish to be considered for the Kumpulan Akitek Arts Scholarship and have enclosed my family s financial documents. For Official Use : Applicant s PCI for Dare to Dream Scholarship : Pending Documents : 1. APPLICANT S PERSONAL PARTICULARS Full Name (As in NRIC/Passport): NRIC No/Passport No: Date of Birth (DD/MM/YY): Age : Applicant ID : Type of Study Please þ tick ; Programme (eg. Fine Arts) : Level of Study Please þ tick ; Diploma BA (Hons) Masters 1 2 3 MA Sem1 Mailing Address: Postal Code : Nationality: Singapore PR: Yes No Email Address: Home No: Mobile No: Highest Qualifications (eg..diploma in Design) : Institution & Country of Issue : Award Year (eg. 2015) : 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 AY2018/2019 : Name of Financial Scheme Eg. Scholarship /Bursary/ Grant Name of Sponsor Eg. Lee Foundation / Mendaki Period of Grant Eg. Aug 2016 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 Note : Students who have obtained approval for the Mendaki TTFS cannot hold a college-administered bursary / scholarship. However, they may apply for the MOE / CDC Bursary. 2. ONLY APPLICANTS OF DARE TO DREAM SCHOLARSHIP & KUMPULAN AKIKTEK ARTS SCHOLARSHIP FAMILY S PERSONAL PARTICULARS (Immediate & non-immediate family members living at the same address.) Relationship to Applicant Full Name (as in NRIC / Passport) Age Occupation (if student, please indicate secondary, poly, Uni) Gross Income / month (SGD) 1. Father 2. Mother 3. Sibling 4. Sibling 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 the 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 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 it s 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

DARE TO DREAM SCHOLARSHIP 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

DARE TO DREAM SCHOLARSHIP 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. g Family Member s Signature Relationship to Applicant Name of Student / Applicant 5